Inflammatory pseudotumor of the liver in a patient with human immunodeficiency virus infection.
A 31 year-old male was admitted for investigation of a hepatic tumor, which was incidentally found during abdominal sonography. Abdominal ultrasound revealed a large heterogeneous hyperechoic mass, 4x6x5cm in size, located at the inferior portion of the medial segment of the liver. Abdominal computed tomography without enhancement showed a hepatic tumor, 6 cm in size, in the medial segment of the liver. Malignancy was suspected in the light of radiological presentation. Therefore, wedge resection of the hepatic tumor was performed. The pathological findings revealed that the hepatic tumor was composed of dense fibrous tissue, plump spindle cells, foamy histiocytes, abundant lymphocytes, plasma cells and macrophages which led to the diagnosis of inflammatory tumor of the liver. The post-operative course was uneventful, and the patient was discharged two weeks after operation. Unfortunately, high fever and persisting headache were noted one week after discharge, thus the patient was re-admitted. The infectious focus was investigated during the second admission. Serological test for anti-human immunodeficiency virus was positive. Computed tomography of the brain revealed inflammatory changes over the territory of right middle cerebral artery. The patient died two weeks after the onset of encephalitis. We believe this to be the first case of inflammatory pseudotumor of the liver associated with human immunodeficiency virus infection.