A 63-year-old female patient with a history of arterial hypertension and no liver disease presented signs of dissociated cholestasis on lab workup. Abdominal ultrasound revealed a liver lesion suspected of malignancy that had not been present on previous imaging studies. Computed tomography and magnetic resonance imaging confirmed a 45-mm lesion between segments V and VIII, with poorly defined edges, satellite nodules, and peripheral enhancement until late phases after the administration of contrast material (Fig. 1A–C). After ruling out the existence of primary tumors in other locations and given the suspicion of an intrahepatic cholangiocarcinoma, we conducted laparoscopic right anterior sectionectomy and lymph node dissection without incident. The pathological study identified a necrotizing epithelioid granulomatous reaction with no evidence of malignancy (Figure 1D). Liver disease, mycobacteria, cytomegalovirus, and echinococcosis studies were completed, all of which were negative.
Diagnosis
Necrotizing hepatic granuloma
Please cite this article as: Blanco Terés L, Di Martino M, de la Hoz Rodríguez Á, Martín-Pérez E. Granuloma hepático simulando un colangiocarcinoma intrahepático: una presentación infrecuente. Cir Esp. 2021;99:383.
