Hepatobiliary and Pancreatic: Peliosis hepatis associated with multiple myeloma

Slim, Raoudha; Hachem, Nabil El; Smayra,; Yaghi, César; Daniel, F; Boujaoudé, J; Honein, Khalil; Sayegh, Raymond; Ghosn, Marwan

doi:10.1111/jgh.12469

Cited by 6 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although benign, asymptomatic, and usually an incidental finding, PH should always be kept in mind as a differential diagnosis of an atypical hypervascular hepatic lesion. The other differential diagnoses would include hepatic adenomas, FNH, Caroli disease, and multiple abscesses [ 7 , 9 , 24 ], although these may have individually distinguishing features. For example, when compared to FNH, most PH lesions demonstrated heterogeneous hyperenhancement during the arterial phase of CEUS, rather than the typical avid homogeneous centrifugal pattern seen with FNH.…”

Section: Discussionmentioning

confidence: 99%

“…Typically, it is difficult to clearly distinguish PH from other hypervascular lesions on imaging studies alone [ 1 ], and a histopathological evaluation is thus necessary. There is, however, an increased risk of bleeding with needle biopsy of vascular lesions [ 9 ] and therefore, the understanding of the imaging features of PH may be helpful for establishing the correct diagnosis, occasionally without the need for sampling.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound findings in peliosis hepatis

Wang

Lim

et al. 2021

Ultrasonography

View full text Add to dashboard Cite

Purpose: The aim of this study was to retrospectively evaluate contrast-enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH).Methods: A retrospective analysis was conducted of CEUS features in 24 patients with histopathologically confirmed PH (11 men and 13 women; mean age, 32.4±7.1 years; range, 28 to 41 years). All lesions were histologically proven, either by core needle biopsy (n=10) or by hepatic surgery (n=14).Results: The mean size was 36.8±12.4 mm (range, 10 to 80 mm). On B-mode ultrasonography (BMUS), all PH lesions were heterogeneously hypoechoic, with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneous hyperenhancement (83.3%, 20/24) or isoenhancement (16.7%, 4/24). Furthermore, 87.5% of the PH lesions showed mild washout after 1 minute in the portal venous phase (30-120 seconds) and mild washout in the late phase (>120 seconds).Conclusion: The lack of a mass effect on BMUS, mild heterogeneous arterial hyperenhancement, and washout in the very late portal venous phase (after 1 minute) on CEUS are characteristic of PH. Although it is a histological diagnosis, PH should be considered in the differential diagnosis when the clinical context does not favor a malignancy or infection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound findings in peliosis hepatis

Wang

Lim

et al. 2021

Ultrasonography

View full text Add to dashboard Cite

show abstract

“…Dilated sinusoidal spaces and hemorrhagic dilated spaces within the liver parenchyma are typical but this requires adequate tissue sampling which can be difficult owing to the dilated sinusoidal spaces involved. In addition, biopsy in peliosis is associated with a high risk of bleeding [85]. The aspirates can also be examined for Bartonella species especially in cases without predisposing factors and corresponding serology for Bartonella antibodies in the blood can also be carried out.…”

Section: Imagingmentioning

confidence: 99%

Comments and illustrations of the WFUMB CEUS liver guidelines: Peliosis hepatis and porphyria

Moller,

Hoffmann,

Zadeh

et al. 2024

Med Ultrason

View full text Add to dashboard Cite

In this series of articles on comments and illustrations of the World Federation for Medicine and Biology (WFUMB) guidelines on contrast-enhanced ultrasound (CEUS), the topics on very rare focal liver lesions (FLL) are discussed. This article describes the diverse changes of focal liver lesions in peliosis hepatis and the typical changes in porphyria. Although the focus is on the appearance on ultrasound and CEUS, the clinical context is always considered. While peliosis may be a surprising finding on puncture, lesions in porphyria cutanea tarda may be typical visual diagnoses that obviate the need for biopsy. If only you knew. This article aims to sharpen the clinician’s eye. It provides knowledge of the clinical presentation and US and CEUS imaging of peliosis hepatis and porphyria.

show abstract