A case of hepatic reactive lymphoid hyperplasia: the review of 23 cases from the literatures

• Published in: Clinical journal of gastroenterology Vol. 16; no. 6; pp. 877 - 883
• Main Authors: Matsuyama, Sho, Fukuda, Akihisa, Omatsu, Risa, Nagao, Munemasa, Okano, Akihiro, Ueo, Taro, Ohana, Masaya, Seno, Hiroshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-12-2023
• Subjects: Abdominal Surgery; Case Report; Colorectal Surgery; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Surgical Oncology; Liver biopsy; Hepatic reactive lymphoid hyperplasia; Hepatic mass; Hepatic pseudolymphoma
• ISSN: 1865-7257; 1865-7265
• DOI: 10.1007/s12328-023-01844-4

A 70-year-old woman was referred to our hospital because of slight elevation of soluble interleukin-2 receptor (sIL-2R) and accumulation of 18F-fluorodeoxyglucose (FDG) in S8 of the liver on positron emission tomography. The mass was strongly suspected to be malignant because of contrast enhancement and enlargement in size of the mass, and suspicion of portal vein invasion. Hepatic S8 subsegmentectomy was performed for diagnostic and therapeutic purposes. Hematoxylin and eosin staining of the resected specimen showed small lymphocytes with no atypia and no formation of lymphoid follicles. Immunostaining showed CD3-positive cells in the interfollicular region and CD20-positive cells in the lymphoid follicles. Both CD10 and BCL-2 were negative in the follicular germinal center. CD138-positive plasma cells were observed and there was no light chain restriction. Based on polyclonal growth pattern of lymphocytes in the lymphoid follicles and interfollicular region, she was diagnosed with hepatic reactive lymphoid hyperplasia (RLH).
Review of the English literature of hepatic RLH which referred to imaging findings yielded 23 cases, including this case. As a result, we suggest that liver biopsy should be performed for definitive diagnosis, when hepatic RLH is suspected by imaging findings and backgrounds.