Multicystic Biliary Hamartoma With Xanthogranulomatous Inflammation on 18F-FDG PET/CT

Abstract

A 70-year-old man with a liver tumor was pathologically diagnosed with multicystic biliary hamartoma with xanthogranulomatous inflammation. Plain CT revealed an inhomogeneous low-density liver tumor, measuring 43 × 35 mm. Dynamic contrast-enhanced CT revealed a cyst, measuring approximately 15 mm, with a ring-shaped enhancement, within the tumor. There was delayed enhancement on the outer portion of the tumor. Mild peripheral bile duct dilation was also observed. 18F-FDG PET/CT showed focal high uptake with an SUVmax of 5.2 near the cyst. The findings of this case mimicked that of intrahepatic cholangiocellular carcinoma.

Subtly Increased Focal FDG Activity in the Liver Due to Paragonimiasis

“…Primary hepatic malignancies or metastases are most commonly considered diagnosis when focal hepatic FDG activity was observed. However, many benign etiologies 7–14 can have similar FDG PET/CT images and are difficult to distinguish based on PET/CT study alone. The MRI features of P. westermani infection of the liver should be considered in this situation.…”