Pseudotumoral Appearance of Peliosis Hepatis

Savastano, Sergio; Bortolo, Ospedale San; Velo, Emanuela; Rettore, Carlo; Altavilla, Giuseppe

doi:10.2214/ajr.185.2.01850558

Cited by 28 publications

(23 citation statements)

References 4 publications

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“…The lesion www.wjgnet.com varies from 1 mm to several centimeters with multiple blood-filled cavities [2,3] . The lesions typically involve the whole liver, but local peliosis hepatis (also called peliosis hepatis pseudotumor) has also been reported [4] , like our case. Yanoff and Rawson [5] have reported two types of the disease: parenchymal and phlebectatic.…”

Section: Discussionsupporting

confidence: 66%

“…However, peliosis hepatis is associated with drugs (anabolic steroids, oral contraceptives, etc), malignant tumor (particularly hepatocellular carcinoma), and chronic infections (pulmonary tuberculosis, leprosy and HIV infections) [2][3][4] . Peliosis hepatis accompanying syphilis infection has not, to our knowledge, previously been reported.…”

Section: Discussionmentioning

confidence: 99%

“…The imaging findings of peliosis hepatis are variable depending on the pathologic patterns, lesion size, extent of communication with sinusoids, and complications such as thrombosis or haemorrhage within the lesion and concomitant hepatic steatosis [2][3][4] . Conventional gray-scale sonography shows hyperechoic lesions in patients with a healthy liver, homogeneous hypoechoic lesions in patients with hepatic steatosis and heterogeneous hypoechoic lesions if complicated by hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional gray-scale sonography shows hyperechoic lesions in patients with a healthy liver, homogeneous hypoechoic lesions in patients with hepatic steatosis and heterogeneous hypoechoic lesions if complicated by hemorrhage. Absence of a mass effect on peripheral blood vessels is considered characteristic of a peliosis hepatis pseudotumor [3,4] . On unenhanced CT, peliotic lesions usually have multiple areas of low attenuation, calcifications and hemorrhage within the lesions have also been described [2] .…”

Section: Discussionmentioning

confidence: 99%

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Peliosis and gummatous syphilis of the liver: A case report

Chen¹,

Chen²,

Zhang³

et al. 2008

WJG

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Peliosis hepatis is a rare benign vascular disorder of the liver that may be associated with malignancy, infection and drugs. The imaging manifestation of this disorder is often variable and nonspecific making its diagnosis difficult. We describe a rare case of peliosis hepatis and gummatous syphilis of the liver with emphasis on CT findings. Image characteristics of our patient included pseudotumoral appearance of peliosis hepatis, isodensity to the adjacent liver parenchyma on unenhanced and dual-phase scanning. To our knowledge, peliosis hepatis associated with syphilis and unique enhancement pattern has not been reported. Considering the imaging features of peliosis hepatis, it should be considered in the differential diagnosis of atypical focal hepatic lesion.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Peliosis and gummatous syphilis of the liver: A case report

Chen¹,

Chen²,

Zhang³

et al. 2008

WJG

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“…By contrast, during the arterial phase of PH, the lesions usually show early globular enhancement. In addition, multiple small accumulations of contrast material in the center and centrifugal progression of enhancement, without a mass effect on hepatic vessels, is present during the portal venous phase, as determined by enhanced CT. Diffuse increased attenuation may be observed during the delayed phase (18–20). Small lesions (diameter, >1 cm) may not be visible on enhanced CT (21) and magnetic resonance images are atypical for such lesions and the lesions may therefore be confused with hematomas, hemangiomas and HCC (2).…”

Section: Discussionmentioning

confidence: 99%

Peliosis hepatis mimicking cancer: A case report

Dai

Zhong

2013

Oncology Letters

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Peliosis hepatis (PH) is a rare condition characterized by the presence of blood-filled cavities within the liver. The etiology of PH remains unknown, but it has been reported to be associated with infections or malignancies. However, the cause of PH is not clear in 20–50% of patients. The current study presents the case of a 19-year-old male who presented with right upper quadrant pain that had lasted for three days. The patient was a student with no previous medical history. Contrast-enhanced computer tomography (CT) and ultrasonography showed a neoplasm in the right liver and a diagnosis of primary liver cancer was made due to the manifestation of the disease and the results of physical tests. The individual was treated successfully with an irregular right hemihepatectomy and was in good health at 6-months post-surgery. A tissue specimen was obtained and determined to be PH by pathological examination and immunohistochemistry analysis. Consequently, a diagnosis of PH must be considered in cases like this.

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MRI of Peliosis Hepatis: A Case Series Presentation With a 2022 Systematic Literature Update

Calistri

Nardi

Rastrelli

et al. 2023

Magnetic Resonance Imaging

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BackgroundPeliosis hepatis (PH) is a rare benign condition, characterized by hepatic sinusoidal dilatation and blood‐filled cystic cavities, often found incidentally, with still challenging diagnosis by imaging due to polymorphic appearance.PurposeBased on a retrospective analysis of our series (12 patients) and systematic literature review (1990–2022), to organize data about PH and identify features to improve characterization.Study TypeRetrospective case series and systematic review.PopulationTwelve patients (mean age 48 years, 55% female) with pathology‐proven PH and 49 patients (mean age 52 years, 67% female) identified in 33 studies from the literature (1990–2022).Field Strength/Sequence1,5‐T; T1‐weighted (T1W), T2‐weighted (T2W), diffusion‐weighted (DW), contrast‐enhanced (CE) T1W imaging.AssessmentWe compared our series and literature data in terms of demographic (gender/age/ethnicity), clinical characteristics (symptoms/physical examination/liver test), associated conditions (malignancies/infectious/hematologic/genetic or chronic disorders/drugs or toxic exposure) percentage. On magnetic resonance imaging lesion numbers/shape/mean maximum diameter/location/mass effect/signal intensity were compared. PH pathological type/proposed imaging diagnosis/patient follow‐up were also considered.Statistical TestsJoanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports/Series quality assessment. Intraclass correlation and Cohen's kappa coefficients for levels of inter/intrareader agreement in our experience.ResultsPatients were mainly asymptomatic (92% vs. 70% in our study and literature) with associated conditions (83% vs. 80%). Lesions showed homogeneous T1W‐hypointensity (58% vs. 65%) and T2W‐hyperintensity (58% vs. 66%). Heterogeneous nonspecific (25% vs. 51%), centrifugal (34% vs. 8%), or rim‐like centripetal (25% vs. 23%) patterns of enhancement were most frequent, with hypointensity on the hepatobiliary phase (HBP), without restricted diffusivity. Good inter‐ and intrareader agreement was observed in our experience. Concerning JBI Checklist, 19 out of 31 case reports met at least 7 out of 8 criteria, whereas 2 case series fulfilled 5 and 6 out of 10 items respectively.Data ConclusionA homogeneous, not well‐demarcated T1W‐hypointense and T2W‐hyperintense mass, with heterogeneous nonspecific or rim‐like centripetal or centrifugal pattern of enhancement, and hypointensity on HBP, may be helpful for PH diagnosis. Among associated conditions, malignancies and drug exposures were the most frequent.Level of Evidence4Technical EfficacyStage 2

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Pseudotumoral Appearance of Peliosis Hepatis

Cited by 28 publications

References 4 publications

Peliosis and gummatous syphilis of the liver: A case report

Peliosis and gummatous syphilis of the liver: A case report

Peliosis hepatis mimicking cancer: A case report

MRI of Peliosis Hepatis: A Case Series Presentation With a 2022 Systematic Literature Update

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