Congenital Portal Vein Aneurysm Associated with Peliosis Hepatis and Intestinal Lymphangiectasia

Mungan, Zeynel; Pınarbaşı, Binnur; Bakir, Barış; Güllüoğlu, Mine; Baran, Bülent; Akyüz, Filiz; Demır, Kadir; Kaymakoğlu, Sabahattin

doi:10.1155/2009/479264

Cited by 10 publications

(3 citation statements)

References 8 publications

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“… 15 More uncommon associations include malignancy such as HCC, cystic fibrosis, celiac disease, intestinal telangiectasia, portal vein aneurysms, Hodgkin's lymphoma, X-linked myotubular myopathy, hereditary haemorrhagic telangiectasia, and idiopathic thrombocytopaenic purpura. 15 27 28 29 Despite the multiple reported associations, no reported association / causative factors have been found in up to 50% of cases.…”

Section: Discussionmentioning

confidence: 99%

Liver lesions detected in a hepatitis B core total antibody-positive patient masquerading as hepatocellular carcinoma: a rare case of peliosis hepatis and a review of the literature

Tan

Soon

Kow

2017

Ann Hepatobiliary Pancreat Surg

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Peliosis Hepatis (PH) is a rare vascular disorder of the liver, characterized by the presence of cystic blood-filled cavities distributed throughout the hepatic parenchyma. The pathogenesis of PH remains controversial. The preoperative diagnosis of PH is difficult, due to the non-specific imaging characteristics of PH and almost all cases are diagnosed on histology post resection. This study presents a case of PH masquerading as hepatocellular carcinoma (HCC). The patient is a 45-year old Chinese lady, who presented with transaminitis. She was found to be hepatitis B virus core total antibody-positive with an alpha-fetoprotein (AFP) of 29.4 ng/ml. Triphasic liver computed tomography showed several arterial hypervascular lesions and hypoenhancing lesions on the venous phase, particularly in the segments 6/7. Subsequently, a magnetic resonance imaging scan showed multiple lesions in the right hemiliver with an indeterminate enhancement patterns. Subsequently, she decided to undergo a resection procedure. Histopathology revealed findings consistent with PH with some unusual features. This case demonstrates a clinical conundrum, in which PH presented with a raised AFP, in a patient with risk factors for the development of HCC. The clinical suspicion of PH should be high in patients, who present with multiple hepatic lesions with variable enhancement patterns.

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Section: Discussionmentioning

confidence: 99%

Liver lesions detected in a hepatitis B core total antibody-positive patient masquerading as hepatocellular carcinoma: a rare case of peliosis hepatis and a review of the literature

Tan

Soon

Kow

2017

Ann Hepatobiliary Pancreat Surg

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“…Its pathogenesis is not completely clear, except for SOS-dependent peliosis, and regardless of the cause, sinusoidal damage has been generally proposed as being critical to outflow blockage and dilation of the sinusoids/central vein of the hepatic lobule[ 120 , 125 ]. Moreover, hepatocellular necrosis may represent another possible mechanism with the subsequent formation of blood-filled lacunae[ 126 , 127 ]. Two different histological forms of peliosis can be identified: the parenchymal type, usually associated with hemorrhagic parenchymal necrosis and characterized by a lack of endothelial lining within the blood-filled lacunae, and the phlebectatic type, with a dilated central vein, showing an endothelial lining within the cystic spaces[ 128 ].…”

Section: Blue Livermentioning

confidence: 99%

Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Calistri¹,

Rastrelli²,

Nardi³

et al. 2021

WJG

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The liver is the major drug-metabolizing and drug-detoxifying organ. Many drugs can cause liver damage through various mechanisms; however, the liver response to injury includes a relatively narrow spectrum of alterations that, regardless of the cause, are represented by phlogosis, oxidative stress and necrosis. The combination of these alterations mainly results in three radiological findings: vascular alterations, structural changes and metabolic function reduction. Chemotherapy has changed in recent decades in terms of the drugs, protocols and duration, allowing patients a longer life expectancy. As a consequence, we are currently observing an increase in chemotherapy-associated liver injury patterns once considered unusual. Recognizing this form of damage in an early stage is crucial for reconsidering the therapy regimen and thus avoiding severe complications. In this frontier article, we analyze the role of imaging in detecting some of these pathological patterns, such as pseudocirrhosis, “yellow liver” due to chemotherapy-associated steatosis-steatohepatitis, and “blue liver”, including sinusoidal obstruction syndrome, veno-occlusive disease and peliosis.

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“…[5][6][7][9][10][11][12][13][14][15][16][17][18] Extrahepatic portal venous aneurysms have been described in the literature. [19][20][21][22][23] However, peripheral intrahepatic portosystemic venous shunts with aneurysms are extremely rare [1][2][3][4][5]13,24 and incidentally discovered. 2,13 In a study of nine cases involving intrahepatic portosystemic venous shunts, De Gaetano et al 4 found that 56% of the cases, without any clinical evidence of liver disease, were incidentally discovered.…”

Section: Discussionmentioning

confidence: 99%

Congenital Intrahepatic Portosystemic Venous Shunt With an Associated Aneurysm: Sonographic Diagnosis

Ghazle

Bollinger

2017

Journal of Diagnostic Medical Sonography

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Intrahepatic portosystemic venous shunts with associated aneurysms are extremely rare anomalous communications between intrahepatic portal veins and systemic veins through intrahepatic venous channels. Intrahepatic portosystemic venous shunts are usually asymptomatic but can be the cause of hepatic encephalopathy and hypoglycemia, especially when a high degree of shunting exists. The sonographic incidental finding of an aneurysmal vascular connection between the left portal vein and left hepatic vein as diagnosed by sonography is presented and discussed. When evaluating patients with suspected symptoms of hepatobiliary disease, sonographers and radiologists should carefully scan and meticulously assess the liver for signs of abnormal venous communications.

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Congenital Portal Vein Aneurysm Associated with Peliosis Hepatis and Intestinal Lymphangiectasia

Cited by 10 publications

References 8 publications

Liver lesions detected in a hepatitis B core total antibody-positive patient masquerading as hepatocellular carcinoma: a rare case of peliosis hepatis and a review of the literature

Liver lesions detected in a hepatitis B core total antibody-positive patient masquerading as hepatocellular carcinoma: a rare case of peliosis hepatis and a review of the literature

Imaging of the chemotherapy-induced hepatic damage: Yellow liver, blue liver, and pseudocirrhosis

Congenital Intrahepatic Portosystemic Venous Shunt With an Associated Aneurysm: Sonographic Diagnosis

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