A unique presentation of peliosis hepatis: A case report and comprehensive review of the literature

Abstract

Introduction: Peliosis hepatis (PH) is a rare benign vascular condition characterized by dilatation of hepatic sinusoids with occasional involvement of other organs. While associated with chronic immunosuppression, anabolic steroid use, oral contraceptive (OCP) use, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and infection with Bartonella, most PH patients are asymptomatic and, thus, identified incidentally. Compromised liver function is sometimes evident through laboratory tests; however, mortality results from cyst rupture and hemorrhage spontaneously or during surgical procedures. Case Report: We report a case of PH identified in a 33-year-old Black female radiologically evaluated for abnormal liver function tests. Computed tomography (CT) revealed enhancement of >100 lesions throughout both liver lobes; a CT-guided biopsy revealed mild macrovesicular steatosis and marked sinusoidal dilation, consistent with peliosis hepatis. Conclusion: We also present a comprehensive literature review describing the associated conditions, pathology, diagnostic methods, and treatment options for PH patients.

Imaging findings of a case of peliosis hepatis mimicking malignancies

“…The natural history of peliosis hepatis often involves regression after cessation of drug use, steroid therapy, or resolution of an associated infectious disease. However, there have been reports of progression to portal hypertension and liver failure and hemorrhagic complication [ [3] , [4] , [5] ].…”

“…However, the observed appearances are nonspecific, with variable enhancement patterns, which can make the diagnosis challenging. In the majority of cases, there are multiple lesions, which may be either a few large lesions or several small lesions [ 3 , 6 ].…”