A case of primary biliary cirrhosis with systemic lymph node enlargement

Abstract

A 60 year-old female was hospitalized for chronic liver injury. Elevation of serum bile duct enzymes and the presence of anti-mitochondrial M2 antibody (36IU/l) supported the presence of primary biliary cirrhosis (PBC). Biopsy of left axillary lymphnode was performed for swollen superficial and peri-hepatic lymph nodes, and revealed reactive lymph-follicular hyperplasia Laparoscopy demonstrated a rough liver surface but neither a red-dish patch nor a ditch-shaped indentation. PBC was histologically proven by the findings of lymphocyte infiltration, granuloma formation and regenerative change of bile ductule epithelium in the portal tracts. The size of superficial lymph nodes was reduced with the improvement of serum liver enzymes during ursodeoxycholicacid (UDCA) treatment, 600mg/day for a year. Reactive lymph-follicular hyperplasia might be associated with the immune response caused by PBC. © 2006 The Japan Society of Hepatology.