Abstract
症例は65歳の男性で，発熱のため近医を受診し，精査目的で当院に紹介となった．血液検査では，高度の炎症反応上昇と胆道系酵素の上昇を認めた．造影CTで肝左葉は著明に萎縮し，左肝管内に肝内結石を認め，その上流側の肝内胆管拡張を認めた．肝S1に6 cm大の多房性病変を認めた．MRIではT1で低信号域，T2では内部に液体成分の貯留を疑う著明な高信号域を伴った不均一な等～高信号域を認めた．炎症反応が高値のため，抗生剤治療を施行した．抗生剤治療後の造影CTでは，腫瘤は最大6 cm大が4 cm大に縮小し，内部の液体成分も著明に縮小した．以上の 検査所見から，肝炎症性偽腫瘍（inflammatory pseudotumor；以下，IPTと略記）を疑ったが，肝萎縮を伴う肝内結石を伴っていたため，肝左葉尾状葉切除を施行した．病理組織学的検査では紡錘形細胞の増生とマクロファージの浸潤，リンパ球を中心とした高度の炎症性細胞浸潤を認め，IPTと診断した．
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