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Hilar Inflammatory Pseudotumour with Hepatic Artery Atheroma- mimicker of Klatskin Tumour

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Abstract

Inflammatory pseudotumour of hilar biliary structures is an extremely rare benign lesion that can mimic hilar cholangiocarcinoma. Clinical presentation and imaging findings often pose diagnostic difficulties. Main histopathological findings are the presence of myofibroblastic spindle cells, plasma cells, macrophages, and lymphocytes without cellular atypia or atypical mitotic figures. We describe a case of 62 year old male who presented with surgical obstructive jaundice. Imaging revealed a mass lesion involving the biliary confluence with upstream dilatation of biliary tree. Diagnosis of hilar cholangiocarcinoma with type III hilar block was made. Intraoperately hilar mass lesion was found which was encasing right hepatic artery with no evidence of metastasis. The patient underwent Right hepatectomy with caudate lobectomy with complete common bile duct (CBD) excision with Roux en Y hepaticojejunostomy. Unexpectedly histopathological examination showed no evidence of malignancy and revealed hilar inflammatory pseudotumour with hepatic artery atherosclerosis. Preoperative imaging, operative management, pathologic diagnosis and literature review are being presented in view of rarity of the case.

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References

  1. Kumar MPS, Marudanayagam R. Klatskin-like lesions. HPB Surgery 2012

  2. Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO (2012) Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 198(3):W217–27

    Article  PubMed  Google Scholar 

  3. Pack GT, Baker HW (1953) Total right hepatic lobectomy. Report of a case. Annals of surgery 138(2):253–258

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Umiker WO, Iverson LC (1954) Post inflammatory tumor of the lung: report of four cases simulating xanthoma, fibroma or plasma cell granuloma. J Thorac Surg 28:55–62

    CAS  PubMed  Google Scholar 

  5. Menias CO, Surabhi VR, Prasad SR, Wang HL, Narra VR, Chintapalli KN. Mimics of cholangiocarcinoma: spectrum of disease. Radiographics. 2008 Jul-Aug;28 (4):1115–29.

  6. Torzilli G, Inoue K, Midorikawa Y, Hui AM, Takayama T, Makuuchi M (2001) Inflammatory pseudotumors of the liver: prevalence and clinical impact in surgical patients. Hepatogastroenterology 48:1118–1123

    CAS  PubMed  Google Scholar 

  7. Deng FT, Li YX, Ye L, Tong L, Yang XP, Chai XQ (2010) Hilar inflammatory pseudotumor mimicking hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int 9:219–221

    PubMed  Google Scholar 

  8. Nonomura A, Minato H, Shimizu K, Kadoya M, Matsui O (1997) Hepatic hilar inflammatory pseudotumor mimicking cholangiocarcinoma with cholangitis and phlebitis–a variant of primary sclerosing cholangitis? Pathol Res Pract 193(7):519–25

    Article  CAS  PubMed  Google Scholar 

  9. Gohy S, Hubert C, Deprez P, Van Beers BE, Annet L, Lhommel R, Sempoux C, Jean-François G. Benign biliary inflammatory pseudotumor mimicking a Klatskin tumor. Hepatogastroenterology. 2007 Jul-Aug;54 (77):1348–52.

  10. Wick MR, Ritter JH. Pseudoneoplastic lesions: An Overview. In: Pathology of pseudoneoplastic lesions. Lippincott Raven Publishers; 1997:1–24

  11. Koide H, Sato K, Fukusato T, Kashiwabara K, Sunaga N, Tsuchiya T et al (2006) Spontaneous regression of hepatic inflammatory pseudotumor with primary biliary cirrhosis: case report and literature review. World J Gastroenterol 12:1645–1648

    PubMed Central  PubMed  Google Scholar 

  12. Saiura A, Umekita N, Inoue S, Maeshiro T, Miyamoto S, Matsui Y, Asakage M, Kawahara Y, Kitamura M. Benign biliary stricture associated with atherosclerosis. Hepatogastroenterology. 2001 Jan-Feb;48 (37):81–2

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Correspondence to Archana Rastogi.

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Rastogi, A., Bihari, C., Gupta, N. et al. Hilar Inflammatory Pseudotumour with Hepatic Artery Atheroma- mimicker of Klatskin Tumour. Indian J Surg Oncol 6, 86–89 (2015). https://doi.org/10.1007/s13193-014-0318-3

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  • DOI: https://doi.org/10.1007/s13193-014-0318-3

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