J Korean Soc Radiol.  2015 Aug;73(2):100-104. 10.3348/jksr.2015.73.2.100.

Inflammatory Pseudotumor in the Liver and Right Omentum Caused by Pelvic Inflammatory Disease: A Case Report

Affiliations
  • 1Department of Radiology, Daegu Fatima Hospital, Daegu, Korea. nosmokeman@naver.com

Abstract

Inflammatory pseudotumor can develop in any part of the human body. It is one of the most important tumor-mimicking lesions that require differential diagnosis. There are various causes of inflammatory pseudotumor, one of which is infection and its resultant inflammation. Pelvic inflammatory disease (PID) often causes perihepatitis, which is called Fitz-Hugh-Curtis syndrome. In Fitz-Hugh-Curtis syndrome, bacteria spread along the right paracolic gutter, causing inflammation of the right upper quadrant peritoneal surfaces and the right lobe of the liver. We experienced a case of PID with accompanying inflammatory pseudotumor in the liver and the right omentum. This case identically correlates with the known intraperitoneal spreading pathway involved in Fitz-Hugh-Curtis syndrome, and hence, we present this case report.


MeSH Terms

Bacteria
Diagnosis, Differential
Female
Granuloma, Plasma Cell*
Human Body
Inflammation
Liver*
Omentum*
Pelvic Inflammatory Disease*

Figure

  • Fig. 1 Abdominal ultrasound shows a 4 cm sized hypoechoic mass (A, arrow) in the right paracolic gutter. A heterogenous hypoechoic lesion (B, arrow) is detected in liver segment #6.

  • Fig. 2 Serial abdominal CT scan shows bilateral tubo-ovarian abscesses (A, arrow) with PID and a well-enhanced mass (B, arrow) in the right paracolic gutter. A heterogenously enhanced lesion (C, arrow) in liver segment #6 with capsular retraction and enhancement is noted. PID = pelvic inflammatory disease

  • Fig. 3 Positron emission tomography CT reveals an intensely increased fluorodeoxyglucose uptake in the right omental mass (arrow).

  • Fig. 4 Pathologic analysis of the mass-like lesion in liver segment #6 (A) and the right omental mass (B) shows infiltration of lymphoplasma cells and lymphocytes (hematoxylin and eosin staining, × 400).


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