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Rare association of solitary necrotic nodule of the liver with rheumatoid arthritis and systemic lupus erythematosus
1Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkiye
2Department of Pathology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkiye
3Department of General Surgery, Acibadem Altunizade Hospital, Istanbul, Turkiye
4Department of Gastroenterology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkiye; Department of Gastroenterology, Acibadem Altunizade Hospital, Istanbul, Turkiye
5Department of Radiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkiye; Department of Radiology, Acibadem Altunizade Hospital, Istanbul, Turkiye
6Department of Radiology, Acibadem Altunizade Hospital, Istanbul, Turkiye
Hepatology Forum 2023; 1(4): 37-39 DOI: 10.14744/hf.2022.2022.0020
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Abstract

Solitary necrotic nodule of the liver (SNNL) is a rare benign lesion with uncertain etiology characterized by a “completely necrotic core” and a hyalinized capsule containing elastin fibers (Journal of Clinical Pathology 36:1181–1183, 1983). We report herein a 26-year-old woman with a previous diagnosis of rheumatoid arthritis, systemic lupus erythematosus, and Sjögren’s syndrome and no history of malignancy who presented with a complaint of diarrhea of 1-year duration. In the abdominal ultrasound, multiple paraaortic, portocaval, and ileal lymphadenopathies (LAPs) have been found with the largest one being 2 cm in size. The biopsy of the iliac LAP showed reactive nodular hyperplasia. An abdominal CT disclosed an incidental hypoechoic, heterogenous mass sized 27 × 27 mm close to segment VI of the liver. A trucut biopsy of this lesion was made, and clinicopathologic features of the specimen were compatible with a solitary necrotic nodule of the liver. Here, we discuss the diagnosis and the clinical course of this rare entity in light of current literature.