RESUMEN
Hepatic reactive lymphoid hyperplasia is an uncommon benign condition, often found incidentally as a solitary liver lesion. The chronic inflammatory reaction associated with autoimmune conditions and malignancies has been postulated as a possible aetiology. The diagnosis is challenging as it often mimics various malignancies radiologically and histologically, hence the diagnosis being made only after surgical resection. Lymphadenopathy is common with primary biliary cholangitis, though rarely reported with reactive lymphoid hyperplasia. We report a case of hepatic reactive lymphoid hyperplasia associated with portacaval lymphadenopathy in a patient with primary biliary cholangitis, diagnosed after surgical resection. We propose lesional biopsy be considered in patients with primary biliary cholangitis found to have a solitary lesion with supporting low-risk clinical and radiological features.
Asunto(s)
Colangitis , Cirrosis Hepática Biliar , Neoplasias Hepáticas , Linfadenopatía , Seudolinfoma , Humanos , Seudolinfoma/diagnóstico , Seudolinfoma/patología , Cirrosis Hepática Biliar/complicaciones , Cirrosis Hepática Biliar/diagnóstico , Neoplasias Hepáticas/diagnósticoRESUMEN
Peritoneal melanosis is an uncommon benign condition, the pathophysiology of which is unclear. Macroscopically, it appears as diffuse dark brown or black pigmentation within the peritoneum, mimicking more sinister conditions such as metastatic melanoma. It has been described in a variety of contexts, but only exceedingly rarely in association with metastatic melanoma, with only two previous published case reports. We present a case of peritoneal melanosis associated with metastatic melanoma involving the spleen, previously treated with targeted and immune checkpoint inhibitor therapy. With increasing reports of melanoma regression manifesting as cutaneous tumorous melanosis in patients treated with immune checkpoint inhibitors, we postulate that, similarly, immunotherapy and tumour regression might have a role to play in the pathogenesis of the peritoneal pigmentation in this case.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Melanoma/terapia , Melanosis/diagnóstico , Enfermedades Peritoneales/diagnóstico , Neoplasias Cutáneas/terapia , Neoplasias del Bazo/cirugía , Biopsia , Quimioterapia Adyuvante , Humanos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Masculino , Melanoma/complicaciones , Melanoma/inmunología , Melanoma/secundario , Melanosis/inducido químicamente , Melanosis/inmunología , Melanosis/patología , Persona de Mediana Edad , Enfermedades Peritoneales/inducido químicamente , Enfermedades Peritoneales/inmunología , Enfermedades Peritoneales/patología , Peritoneo/efectos de los fármacos , Peritoneo/inmunología , Peritoneo/patología , Tomografía de Emisión de Positrones , Inhibidores de Proteínas Quinasas/efectos adversos , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/patología , Bazo/diagnóstico por imagen , Bazo/patología , Bazo/cirugía , Esplenectomía , Neoplasias del Bazo/diagnóstico , Neoplasias del Bazo/secundarioRESUMEN
Foramen of Winslow hernias is a rare and challenging diagnosis as signs and symptoms are usually non-specific. CT imaging has become the method of choice in diagnosing such conditions preoperatively. Traditionally managed via laparotomy, there has been an increase in the use of the minimally invasive technique in recent times, though experience remains sparse. This is a case of a 73-year-old woman with hepatic flexure herniation through the foramen of Winslow who was managed by the traditional laparotomy approach. A review of the literature was performed to learn key techniques in the use of laparoscopy to manage future cases.