Hyperechoic pseudotumors in segment IV of the liver.

Rubaltelli, Léopoldo; Savastano, Sergio; Cellini, Lisa; Zambotti, B; Marchioro, U

doi:10.7863/jum.1997.16.9.569

Cited by 10 publications

(2 citation statements)

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“…2,3 However, hepatocellular carcinoma (HCC) arising in IPH is rare. [2][3][4] We encountered a patient with HCC that developed six and a half years after a diagnosis of IPH. The patient was a 69-year-old woman.…”

Section: Hepatocellular Carcinoma Developing Six and A Half Years Aftmentioning

confidence: 98%

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Multiple hepatic pseudotumors on sonography

et al. 2007

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Hepatic pseudotumors mimicking metastatic disease detected on ultrasonography are usually located in a specifi c part of the liver. For instance, hypoechoic pseudotumors found in the fatty liver are frequently located in the gall bladder fossa or anterior part to the portal vein. 1 On the other hand, hyperechoic pseudotumors due to focal fatty infi ltration are found mainly in the medial segment of the left lobe. 2 However, such pseudotumors usually do not spread over the liver. 3 We have experienced a rare case of multiple hyperechoic pseudotumors spreading to the whole liver.A 58-year-old man, who drank approximately 550 ml of sake (50 g of ethanol) a day, visited us for a liver function test. Blood analyses showed an increase in α-glutamyl transpeptidase (163 IU/ l), but other liver function data as well as complete blood cell counts were within normal limits. Tumor markers including α-fetoprotein (5.9 ng/ml), carcinoembryonic antigen (4.2 ng/ml), and carbohydrate antigen 19-9 (6.2 U/ml) were also in the normal range. Ultrasonography showed a number of high-echogenic ovalshaped areas with diameters of around 1 cm throughout the liver (Fig. 1A). Computed tomography (CT) demonstrated the presence of multiple low-density areas (Fig. 1B) that were slightly enhanced in the arterial phase (Fig. 1C) and then enhanced equally in the surrounding tissues in the subsequent portal phase of the dynamic study (data not shown). Similar fi ndings were obtained when the patient was examined by CT hepatic arteriography and CT arterial portography. No remarkable fi nding was obtained when he was examined by magnetic resonance imaging (MRI) or positron emission tomography. Sonographically guided biopsy specimens showed slight fatty degeneration of hepatocytes (Fig. 1D). The follow-up sonographic examination after 12 months showed little change in the shape of pseudotumors.Nodular parenchymal fatty infi ltration has been reported as a cause of the hyperechogenicity of most pseudotumors. 1-3 Nonportal venous supply to the liver has been suggested to contribute to focal fat deposits. 4 However, in the present case, only a slight fatty change was observed in the biopsy specimens, and thus the histological background of the echogenicity remains to be further elucidated.Multifocal pseudotumors mimicking metastatic tumors are sometimes encountered on diagnostic modalities including ultrasonography, CT, and MRI. 5 Confi rmation of diagnosis often requires invasive procedures, and thus such lesions are still of clinical relevance. The present case may be informative for diagnosing multiple tumorous lesions of the liver.

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Section: Hepatocellular Carcinoma Developing Six and A Half Years Aftmentioning

confidence: 98%

“…1 On the other hand, hyperechoic pseudotumors due to focal fatty infi ltration are found mainly in the medial segment of the left lobe. 2 However, such pseudotumors usually do not spread over the liver. 3 We have experienced a rare case of multiple hyperechoic pseudotumors spreading to the whole liver.…”

Section: Multiple Hepatic Pseudotumors On Sonographymentioning

confidence: 99%