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Medicina Interna

Print version ISSN 0872-671X


MAIA, Raquel et al. IGG4 Related Inflammatory Pseudotumor of the Liver: Particularities of a Rare Diagnosis. Medicina Interna [online]. 2018, vol.25, n.1, pp.43-46. ISSN 0872-671X.

Liver´s inflammatory pseudotumor (LIP) is a rare, benign, nonneoplastic mass, that constitutes an exaggerated inflammatory response to an aggression – infection/trauma/autoimmune disease. Recently, an IgG4-related LIP has been recognized. We present a 57-year-old male with prostatic adenocarcinoma and chronic alcoholism with fever and abdominal pain. Laboratory tests showed leucocytosis (16100/uL), elevated C-reactive protein (52.7 mg/dL), high sedimentation rate (130 mm/h) and hepatic cytolysis. Hepatic nodules, suspicious of secondary/primary lesions were observed by computerized tomography. Alpha-fetoprotein and serotypes for hepatotropic viruses were negative. Streptococcus viridans was isolated in the blood cultures and targeted antibiotic therapy was started. Fever disappeared but hepatic lesions remained. Increased level of serum IgG4 (188 mg/dL) was observed. The liver biopsy showed myofibroblast proliferation with storiform pattern, suggesting LIP, and IgG4+ plasmocytes. Steroid therapy was initiated successfully. The diagnosis of IgG4 related LIP is rare, however, the prognosis is usually good after a course of steroid therapy.

Keywords : Immunoglobulin G; Liver Neoplasms.

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