Hamartomatous lesion of the liver in an adult patient with biliary dilatations: a variant of inflammatory pseudotumor of the liver?

Abstract

An unusual tumor-like lesion (1.2 cm in diameter) in the left lobe of the liver in a 67-year-old woman with dilatations of the common and hepatic bile ducts is reported. Histologically, this lesion was composed of hyalinized connective tissue, several dilated bile ducts with periductal fibrosis and biliary epithelial proliferation, lymphocytic and plasmacytic infiltrates, stenotic venous and arterial vasculature, and nerve bundles. Although these elements were found in a disordered pattern and appeared to have a hamartomatous etiology, each of these pathologic components seemed inflammatory in character. Besides, clinical data disclosed that this lesion was acquired in origin. Although such a hepatic tumor-like lesions has not previously been reported to the best of our knowledge, this tumorous lesion shared features of hepatobiliary lesions reported in intrahepatic calculi, a form of chronic cholangitis. It seems likely that this tumor-like lesion might have arisen from localized chronic cholangitis, possibly related to the dilatations of the common and hepatic ducts, and we suggest that this lesion be named "fibroductal variant" of inflammatory pseudotumor of the liver.