Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

Kim, Eun-A; Yoon, Kwon‐Ha; Jeon, Se-Jung; Cai, Quanyu; Lee, Young-Whan; Yoon, Seong Eon; Yoon, Kyungho; Juhng, Seon Kwan

doi:10.3348/kjr.2007.8.1.64

Cited by 31 publications

(23 citation statements)

References 8 publications

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“…Adam et al [17] and Toth et al [18] reported cases of PH rupture located in the left lobe of liver. But in other cases, the right lobe of the liver was the location of rupture [9,[19][20][21][22] , including the current case. Although Saatci et al [23] reported a case of PH with multiple foci involving both right and left lobes by magnetic resonance imaging, the location of PH in most cases was unilobar, which may be explained by the distribution of hepatic blood flow.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous liver rupture in a patient with peliosis hepatis:A case report

Choi¹,

Jin²,

Cho³

et al. 2009

WJG

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Peliosis hepatis is a rare pathological entity and may cause fatal hepatic hemorrhage and liver failure. Here, we present a young male patient with aplastic anemia, who had received long-term treatment with oxymetholone. The patient suffered from sudden onset of intra-abdominal hemorrhage with profuse hemoperitoneum. The patient was treated successfully with a right hemihepatectomy and is in good health after 13 postoperative months. We suggest that peliosis hepatis be considered in patients with hepatic parenchymal hematoma, especially in patients under prolonged synthetic anabolic steroid medication. The possibility of a potentially life-threatening complication of massive intra-abdominal bleeding should also be considered.

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Section: Discussionmentioning

confidence: 99%

Spontaneous liver rupture in a patient with peliosis hepatis:A case report

Choi¹,

Jin²,

Cho³

et al. 2009

WJG

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“…In the case of hemorrhage, PH lesions appear as hyperattenuating structures on unenhanced CT. Hepatic angiography discloses a typical appearance of PH lesions that accumulate contrast in the late arterial or parenchymal phase and retain it through the early venous phase. [7,8] In our patient, an abdomen CT scan showed hepatomegaly with heterogeneous enhancement of liver parenchyma. A Liver biopsy is the most rewarding tool in diagnosing PH.…”

Section: Case Reportmentioning

confidence: 99%

“…Prognosis is largely determined by the underlying cause and is generally guarded. [6][7][8][9][10] Herein, we present a case of a young female presenting in her seventh month of gestational amenorrhea with signs of portal hypertension and subsequently diagnosed to have PH.…”

Section: Introductionmentioning

confidence: 99%

Peliosis hepatis complicating pregnancy: A rare entity

Butt

Luck

Hassan

et al. 2017

Journal of Translational Internal Medicine

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Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition. Herein, we present a case of a young female presenting in her seventh month of gestational amenorrhea with signs of portal hypertension and subsequently diagnosed to have PH. She was managed conservatively and delivered her baby normally. Later, she presented with spontaneous bacterial peritonitis and hepatic encephalopathy and developed hepatorenal syndrome. She later succumbed to her illness. The condition should be kept in the differential diagnosis of the atypical liver masses and liver diseases causing portal hypertension.

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“…Difficulties have been associated with making a definite preoperative diagnosis of well‐differentiated PHCC on imaging including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) scans …”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic analysis of the simple nodular type of well‐differentiated hepatocellular carcinoma with extensive peliotic change

Nomura

Nakashima

Kumabe

et al. 2014

J of Gastro and Hepatol

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Background and Aim Peliosis hepatis‐like blood‐filled cavities are frequently observed in hepatocellular carcinoma (HCC). Peliotic change (PC) is commonly seen in moderately differentiated HCCs and rarely in well‐differentiated HCCs. We conducted clinicopathological analysis of well‐differentiated HCC with PC (PHCC). Methods A total of 1225 patients underwent hepatectomy at Kurume University Hospital between 1992 and 2010. Of these, 101 cases were diagnosed as well‐differentiated HCC. Immunohistochemical double staining of CD34 and α smooth muscle actin was performed to examine the number and diameter of arterial blood vessels and drainage veins around tumors. We compared the clinical manifestations, histopathological features, and imaging findings of these cases. Results Seven cases of 101 well‐differentiated HCCs had PC. Almost of PHCCs were macroscopically classified as the simple nodular type with a fibrous capsule, and microscopically showed thin trabecular arrangement of tumor cells and extensive dilated sinusoid‐like structures filled with red blood cells. The number of arteries inside the tumor was significantly higher in PHCCs than in the simple nodular type of well‐differentiated HCCs without PC. Furthermore, no significant differences were observed in the ratio of the number of irregularly shaped drainage veins around the tumor to the tumor diameter. Imaging revealed that most of the tumors had capsule‐like structures and showed prolonged enhancement in the delayed phase of dynamic study of imagings. Conclusion PC is unusually observed in well‐differentiated HCC and the size of PHCC was larger than that of well‐differentiated HCC without PC and most are detected as a hypervascular tumor on images.

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Peliosis Hepatis with Hemorrhagic Necrosis and Rupture: a Case Report with Emphasis on the Multi-Detector CT Findings

Cited by 31 publications

References 8 publications

Spontaneous liver rupture in a patient with peliosis hepatis:A case report

Spontaneous liver rupture in a patient with peliosis hepatis:A case report

Peliosis hepatis complicating pregnancy: A rare entity

Clinicopathologic analysis of the simple nodular type of well‐differentiated hepatocellular carcinoma with extensive peliotic change

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