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Hepatic Inflammatory Pseudotumor
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Biliary inflammatory pseudotumor
              • Inflammatory myofibroblastic tumor (IMT)
            • Definitions

              • Heterogeneous group of lesions occurring in liver and bile ducts (among other organs) characterized by fibroblastic and myofibroblastic proliferation with inflammatory infiltrate

            IMAGING

            • General Features

              • Imaging Recommendations

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Ultrasonographic Findings

                        • Nuclear Medicine Findings

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Chen CB et al: Hepatic inflammatory pseudotumor mimicking hepatocellular carcinoma. J Chin Med Assoc. 76(5):299-301, 2013
                                            2. Fernandes T et al: Peripheral inflammatory pseudotumor of the liver and extensive thrombosis of the portal venous system in a child. Pediatr Radiol. 43(8):1041-4, 2013
                                            3. Nagarajan S et al: Inflammatory myofibroblastic tumor of the liver in children. J Pediatr Gastroenterol Nutr. 57(3):277-80, 2013
                                            4. Alswat K et al: The spectrum of sclerosing cholangitis and the relevance of IgG4 elevations in routine practice. Am J Gastroenterol. 107(1):56-63, 2012
                                            5. Carruthers MN et al: The latest on IgG4-RD: a rapidly emerging disease. Curr Opin Rheumatol. 24(1):60-9, 2012
                                            6. Beauchamp A et al: Inflammatory myofibroblastic tumor of the liver in an elderly woman following a second liver biopsy: a case report. Bol Asoc Med P R. 103(2):60-4, 2011
                                            7. Dechoux S et al: IgG4-related sclerosing disease: autoimmune pancreatitis (AIP) and IgG4-related cholangitis. Clin Res Hepatol Gastroenterol. 35(10):601, 2011
                                            8. Herek D et al: Education and imaging. Hepatobiliary and pancreatic: inflammatory pseudotumors of the liver. J Gastroenterol Hepatol. 26(7):1217, 2011
                                            9. Kim F et al: IgG4-related tubulointerstitial nephritis and hepatic inflammatory pseudotumor without hypocomplementemia. Intern Med. 50(11):1239-44, 2011
                                            10. Vlachou PA et al: IgG4-related sclerosing disease: autoimmune pancreatitis and extrapancreatic manifestations. Radiographics. 31(5):1379-402, 2011
                                            11. Deng FT et al: Hilar inflammatory pseudotumor mimicking hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int. 9(2):219-21, 2010
                                            12. Sevinç AI et al: Inflammatory myofibroblastic tumour (IMT) of the liver: a report of two cases. Acta Chir Belg. 110(1):87-9, 2010
                                            13. Tang L et al: Inflammatory myofibroblastic tumor of the liver: a cohort study. World J Surg. 34(2):309-13, 2010
                                            14. Anderson SW et al: Benign hepatic tumors and iatrogenic pseudotumors. Radiographics. 29(1):211-29, 2009
                                            15. Ashcroft MW et al: Biliary inflammatory pseudotumour: report of two cases and review of the literature. Clin Radiol. 64(4):449-55, 2009
                                            16. Blachar A et al: Liver lesions with hepatic capsular retraction. Semin Ultrasound CT MR. 30(5):426-35, 2009
                                            17. Ganesan K et al: Capsular retraction: an uncommon imaging finding in hepatic inflammatory pseudotumour. Br J Radiol. 82(984):e256-60, 2009
                                            18. Goldsmith PJ et al: Inflammatory pseudotumours of the liver: a spectrum of presentation and management options. Eur J Surg Oncol. 35(12):1295-8, 2009
                                            19. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                            20. Yamamoto H et al: Inflammatory myofibroblastic tumor versus IgG4-related sclerosing disease and inflammatory pseudotumor: a comparative clinicopathologic study. Am J Surg Pathol. 33(9):1330-40, 2009
                                            21. Liu YW et al: Hepatic pseudotumor in long-standing biliary atresia patients undergoing liver transplantation. Liver Transpl. 13(11):1545-51, 2007
                                            22. Tublin ME et al: Biliary inflammatory pseudotumor: imaging features in seven patients. AJR Am J Roentgenol. 188(1):W44-8, 2007
                                            23. Koide H et al: Spontaneous regression of hepatic inflammatory pseudotumor with primary biliary cirrhosis: case report and literature review. World J Gastroenterol. 12(10):1645-8, 2006
                                            24. Sasahira N et al: Inflammatory pseudotumor of the liver and peripheral eosinophilia in autoimmune pancreatitis. World J Gastroenterol. 11(6):922-5, 2005
                                            25. Zen Y et al: IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis?. Am J Surg Pathol. 28(9):1193-203, 2004
                                            26. Lee SL et al: Hepatic inflammatory pseudotumor: case report, review of the literature, and a proposal for morphologic classification. Pediatr Surg Int. 17(7):555-9, 2001
                                            27. Torzilli G et al: Inflammatory pseudotumors of the liver: prevalence and clinical impact in surgical patients. Hepatogastroenterology. 48(40):1118-23, 2001
                                            28. Nam KJ et al: Inflammatory pseudotumor of the liver: CT and sonographic findings. AJR Am J Roentgenol. 1996 Aug;167(2):485-7. Erratum in: AJR Am J Roentgenol. 167(6):1598, 1996
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Biliary inflammatory pseudotumor
                                                        • Inflammatory myofibroblastic tumor (IMT)
                                                      • Definitions

                                                        • Heterogeneous group of lesions occurring in liver and bile ducts (among other organs) characterized by fibroblastic and myofibroblastic proliferation with inflammatory infiltrate

                                                      IMAGING

                                                      • General Features

                                                        • Imaging Recommendations

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Chen CB et al: Hepatic inflammatory pseudotumor mimicking hepatocellular carcinoma. J Chin Med Assoc. 76(5):299-301, 2013
                                                                                      2. Fernandes T et al: Peripheral inflammatory pseudotumor of the liver and extensive thrombosis of the portal venous system in a child. Pediatr Radiol. 43(8):1041-4, 2013
                                                                                      3. Nagarajan S et al: Inflammatory myofibroblastic tumor of the liver in children. J Pediatr Gastroenterol Nutr. 57(3):277-80, 2013
                                                                                      4. Alswat K et al: The spectrum of sclerosing cholangitis and the relevance of IgG4 elevations in routine practice. Am J Gastroenterol. 107(1):56-63, 2012
                                                                                      5. Carruthers MN et al: The latest on IgG4-RD: a rapidly emerging disease. Curr Opin Rheumatol. 24(1):60-9, 2012
                                                                                      6. Beauchamp A et al: Inflammatory myofibroblastic tumor of the liver in an elderly woman following a second liver biopsy: a case report. Bol Asoc Med P R. 103(2):60-4, 2011
                                                                                      7. Dechoux S et al: IgG4-related sclerosing disease: autoimmune pancreatitis (AIP) and IgG4-related cholangitis. Clin Res Hepatol Gastroenterol. 35(10):601, 2011
                                                                                      8. Herek D et al: Education and imaging. Hepatobiliary and pancreatic: inflammatory pseudotumors of the liver. J Gastroenterol Hepatol. 26(7):1217, 2011
                                                                                      9. Kim F et al: IgG4-related tubulointerstitial nephritis and hepatic inflammatory pseudotumor without hypocomplementemia. Intern Med. 50(11):1239-44, 2011
                                                                                      10. Vlachou PA et al: IgG4-related sclerosing disease: autoimmune pancreatitis and extrapancreatic manifestations. Radiographics. 31(5):1379-402, 2011
                                                                                      11. Deng FT et al: Hilar inflammatory pseudotumor mimicking hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int. 9(2):219-21, 2010
                                                                                      12. Sevinç AI et al: Inflammatory myofibroblastic tumour (IMT) of the liver: a report of two cases. Acta Chir Belg. 110(1):87-9, 2010
                                                                                      13. Tang L et al: Inflammatory myofibroblastic tumor of the liver: a cohort study. World J Surg. 34(2):309-13, 2010
                                                                                      14. Anderson SW et al: Benign hepatic tumors and iatrogenic pseudotumors. Radiographics. 29(1):211-29, 2009
                                                                                      15. Ashcroft MW et al: Biliary inflammatory pseudotumour: report of two cases and review of the literature. Clin Radiol. 64(4):449-55, 2009
                                                                                      16. Blachar A et al: Liver lesions with hepatic capsular retraction. Semin Ultrasound CT MR. 30(5):426-35, 2009
                                                                                      17. Ganesan K et al: Capsular retraction: an uncommon imaging finding in hepatic inflammatory pseudotumour. Br J Radiol. 82(984):e256-60, 2009
                                                                                      18. Goldsmith PJ et al: Inflammatory pseudotumours of the liver: a spectrum of presentation and management options. Eur J Surg Oncol. 35(12):1295-8, 2009
                                                                                      19. Kamaya A et al: Hypervascular liver lesions. Semin Ultrasound CT MR. 30(5):387-407, 2009
                                                                                      20. Yamamoto H et al: Inflammatory myofibroblastic tumor versus IgG4-related sclerosing disease and inflammatory pseudotumor: a comparative clinicopathologic study. Am J Surg Pathol. 33(9):1330-40, 2009
                                                                                      21. Liu YW et al: Hepatic pseudotumor in long-standing biliary atresia patients undergoing liver transplantation. Liver Transpl. 13(11):1545-51, 2007
                                                                                      22. Tublin ME et al: Biliary inflammatory pseudotumor: imaging features in seven patients. AJR Am J Roentgenol. 188(1):W44-8, 2007
                                                                                      23. Koide H et al: Spontaneous regression of hepatic inflammatory pseudotumor with primary biliary cirrhosis: case report and literature review. World J Gastroenterol. 12(10):1645-8, 2006
                                                                                      24. Sasahira N et al: Inflammatory pseudotumor of the liver and peripheral eosinophilia in autoimmune pancreatitis. World J Gastroenterol. 11(6):922-5, 2005
                                                                                      25. Zen Y et al: IgG4-related sclerosing cholangitis with and without hepatic inflammatory pseudotumor, and sclerosing pancreatitis-associated sclerosing cholangitis: do they belong to a spectrum of sclerosing pancreatitis?. Am J Surg Pathol. 28(9):1193-203, 2004
                                                                                      26. Lee SL et al: Hepatic inflammatory pseudotumor: case report, review of the literature, and a proposal for morphologic classification. Pediatr Surg Int. 17(7):555-9, 2001
                                                                                      27. Torzilli G et al: Inflammatory pseudotumors of the liver: prevalence and clinical impact in surgical patients. Hepatogastroenterology. 48(40):1118-23, 2001
                                                                                      28. Nam KJ et al: Inflammatory pseudotumor of the liver: CT and sonographic findings. AJR Am J Roentgenol. 1996 Aug;167(2):485-7. Erratum in: AJR Am J Roentgenol. 167(6):1598, 1996