A case of postoperative hepatic granuloma presumptively caused by surgical staples/clipping materials

Diagnostic Pathology

Kazutoshi Shibuya³  Yasukiyo Sumino¹  Hironori Kaneko²  Manabu Watanabe¹  Tetsuo Nemoto³  Megumi Wakayama³  Naobumi Tochigi³  Yoichiro Okubo³  Yuichiro Otsuka²  Takao Ishiwatari³  Yasuhiro Nihon-Yanagi³ 

[1] Division of Gastroenterology and Hepatology; Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, 143-8541, Tokyo, Japan;Department of General and Gastroenterological Surgery, Toho University School of Medicine, 6-11-1 Omori-Nishi,, Ota-Ku, 143-8541, Tokyo, Japan;Department of Surgical Pathology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, 143-8541, Tokyo, Japan

关键词: Titanium;    Stapler;    Staple;    Metal hypersensitivity;    Hepatic granuloma;   

Others  :  1219355
DOI  :  10.1186/s13000-015-0291-3

 received in 2014-10-20, accepted in 2015-05-05,  发布年份 2015

【 摘 要 】

A 66-year-old man with postsigmoidectomy status for colon cancer received laparoscopic partial hepatectomy due to a hepatic mass with employing titanium clips were for a vascular clamp. Histological examination showed liver metastasis from sigmoid colon cancer. Twenty-nine months after the partial hepatectomy, a mass developed on the stump at the hepatic resection. Laparoscopic left lateral segmentectomy was conducted under suspicion of cancer recurrence and an automatic titanium stapling device was used. The macroscopically cut surface of the liver showed a grey-white solid nodule measuring 23 x 20 mm and involving metal clips. The nodule was consistent with granuloma microscopically. Twenty-three months after the segmentectomy, a mass reappeared on the hepatic radial margin and an open left lateral hepatic lobectomy was performed because of its growth tendency. Histopathological examination revealed granuloma similar to the previous instance. Since these nodules formed a granulomatous lesion surrounding metal staples/clips and evidence of caseous necrosis was lacking, granuloma due to surgical staples/clips was suspected. Sporadic case reports of postoperative pulmonary granuloma at the staple line have been published previously, but there are no articles detailing a case involving hepatic granuloma. We present our case as the first report of postoperative staple-line hepatic granuloma.

【 授权许可】

   
2015 Nihon-Yanagi et al.

【 图 表 】

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