肝脏炎性假瘤(IPT)和肝脏炎性假瘤样病变的临床病理特征和预后。

IF 3.9 2区 医学 Q2 CELL BIOLOGY
Histopathology Pub Date : 2024-10-31 DOI:10.1111/his.15357
Eric D Nguyen, Kwun Wah Wen, Sanjay Kakar, Dana J Balitzer
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引用次数: 0

摘要

目的:肝脏炎性假瘤(IPTs)是一种非肿瘤性肝脏肿块,其特征是不同程度的纤维化基质和炎性浸润,被认为是对感染或之前手术的反应的一部分。本研究旨在评估活检证实的肝IPT以及其他具有IPT类似组织学特征的病例的临床病理特征和预后:通过数据库搜索,我们发现了2000年至2023年间病理诊断为肝IPT的病例(n = 80)。对组织学特征(基质质量、炎症细胞成分、肉芽肿和坏死)进行了评估。对既往病史和手术史、微生物学研究和结果进行了回顾性分析。患者多有恶性肿瘤(34%)、胆道疾病(15%)或腹腔内手术(24%)的既往病史,并常伴有多灶性肝脏病变(36%)。炎症背景多种多样,包括组织细胞性(36%)、淋巴浆细胞性(34%)或中性粒细胞性(24%)。15%的病例确定了特定的微生物,最常见的是克雷伯氏菌和葡萄球菌。大多数有临床随访的患者放射学症状消失和/或活检重复阴性;少数患者(8%)随后被诊断为肝肿瘤性病变。组织学特征与随后的肝肿瘤性病变临床或病理诊断之间无明显关联:肝IPT是一种异质性病变,可表现为多种临床症状,形态谱也很广。这些病变通常会自发消退或经抗生素治疗后消退。一部分具有肝IPT组织学特征的病例随后被诊断为恶性肿瘤,这强调了根据临床和放射学特征进行持续随访和重复活检的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinicopathologic features and outcomes of hepatic inflammatory pseudotumour (IPT) and hepatic IPT-like lesions.

Aims: Hepatic inflammatory pseudotumours (IPTs) are nonneoplastic hepatic masses characterized by variably fibroblastic stroma and inflammatory infiltrate, hypothesized to arise as part of a response to infection or prior surgery. The aim of this study was to evaluate the clinicopathologic features and outcomes of biopsy-proven hepatic IPT as well as other cases with IPT-like histologic features.

Methods and results: A database search at our institution identified cases with a pathologic diagnosis of hepatic IPT (n = 80) between 2000 and 2023. Histologic features (stromal quality, inflammatory cell components, granulomas, and necrosis) were evaluated. Past medical and surgical history, microbiologic studies, and outcomes were reviewed retrospectively. Patients frequently had a past medical history of malignancy (34%), biliary disease (15%), or prior intraabdominal surgery (24%), and often presented with multifocal hepatic lesions (36%). Variable inflammatory backgrounds were present, including histiocytic (36%), lymphoplasmacytic (34%), or neutrophilic (24%). Specific organisms were identified in 15% of cases, most commonly Klebsiella and Staphylococcus species. Most patients with available clinical follow-up demonstrated radiologic resolution and/or had repeat negative biopsy; a minority of patients (8%) were subsequently diagnosed with neoplastic hepatic lesions. No significant association was seen between histologic features and the subsequent clinical or pathologic diagnosis of hepatic neoplastic lesions.

Conclusions: Hepatic IPT is a heterogeneous entity that can present in a variety of clinical scenarios and show a wide morphologic spectrum. These lesions often regress spontaneously or with antibiotics. A subset of cases with hepatic IPT-like histologic features were subsequently diagnosed with malignancy, emphasizing the need for continued follow-up and repeat biopsy depending on clinical and radiologic features.

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来源期刊
Histopathology
Histopathology 医学-病理学
CiteScore
10.20
自引率
4.70%
发文量
239
审稿时长
1 months
期刊介绍: Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.
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