A case of pseudolymphoma of the liver with chronic hepatitis C

A case of pseudolymphoma (reactive lymphoid hyperplasia) of the liver in a 72-year-old male with chronic hepatitis C is presented. Imaging studies, comprising ultrasonography, computed tomography, incremental computed tomography, and magnetic resonance imaging, suggested hepatocellular carcinoma. A tumor-like lesion was therefore resected. Grossly, the lesion was relatively poorly defined and measured 15 x 17 mm; microscopically, it consisted of lymphocytic proliferations forming follicles comprising numerous germinal centers that were mainly composed of L-26 positive B-cell lymphocytes. The lymphocytes surrounding germinal centers were mainly UCHL-1 positive T lymphocytes. The B cells in the lymphoid follicles stained positive for both kappa and lambda light chains at sequential frequencies, indicating polyclonal and benign features. These findings suggest that the diagnosis of pseudolymphoma of the liver is tenable from imaging studies supplemented, when necessary, with biopsy. Further studies may provide insights into diagnostic strategies and the mechanism of stimulation in HCV infections.