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Gatti M, Maino C, Tore D, Carisio A, Darvizeh F, Tricarico E, Inchingolo R, Ippolito D, Faletti R. Benign focal liver lesions: The role of magnetic resonance imaging. World J Hepatol 2022; 14:923-943. [PMID: 35721295 PMCID: PMC9157713 DOI: 10.4254/wjh.v14.i5.923] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/07/2021] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
Liver lesions are common findings in radiologists’ daily routine. They are a complex category of pathology that range from solitary benign lesions to primary liver cancer and liver metastases. Benign focal liver lesions can arise from different liver cell types: Epithelial (hepatocytes and biliary cells) and nonepithelial (mesenchymal cells). Liver magnetic resonance imaging (MRI) is a fundamental radiological method in these patients as it allows with its multiparametric approach optimal non-invasive tissue characterization. Furthermore, advanced liver MRI techniques such as diffusion-weighted imaging and hepatobiliary contrast agents have improved the detection of focal liver lesions and can be highly effective in differentiating pseudotumor from tumors, as well as benign from malignant lesions, and can also be used for differential diagnosis. Although histological examination can be useful in making a definitive diagnosis, MRI is an important modality in the diagnosis of liver lesions with a significant impact on patient care. This aim of this review is to provide a comprehensive overview of benign liver lesions on MRI.
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Affiliation(s)
- Marco Gatti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Cesare Maino
- Department of Diagnostic Radiology, Ospedale San Gerardo, Monza 20900, Italy
| | - Davide Tore
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Andrea Carisio
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Fatemeh Darvizeh
- School of Medicine, Vita-Salute San Raffaele University, Milan 20121, Japan
| | | | - Riccardo Inchingolo
- Interventional Radiology Unit, “F. Miulli” Regional General Hospital, Acquaviva delle Fonti 70021, Italy
| | - Davide Ippolito
- Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, Monza 20900, Italy
- Department of Diagnostic Radiology, Ospedale San Gerardo, Monza 20900, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
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Parmeggiani A, Baldazzi M, Carfagnini F, Vivacqua D, Golfieri R, Lovato L, Greco L. Extensive solitary lymphatic malformation of the liver in a child: a case report and literature review. Radiol Case Rep 2022; 17:427-433. [PMID: 34917222 PMCID: PMC8666449 DOI: 10.1016/j.radcr.2021.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
Intrabdominal lymphatic malformations are rare benign congenital vascular anomalies that account for less than 5% of benign masses in childhood, with an extremely variable clinical presentation. For this reason, although their radiological appearance is usually typical, diagnosis can be challenging and not always immediate. This report describes a unique case of extensive solitary hepatic lymphatic malformation in a 10-year-old boy with both extra- and intraparenchymal development with no associated symptoms. A literature review of reported cases of solitary hepatic lymphatic malformation is also included.
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Affiliation(s)
- Anna Parmeggiani
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Michelangelo Baldazzi
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Filomena Carfagnini
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Donatella Vivacqua
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Luigi Lovato
- Cardio-Thoracic Radiology Unit, Cardio-Thoracic-Vascular Department, St. Orsola Hospital, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Laura Greco
- Pediatric Radiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Long X, Zhang L, Cheng Q, Chen Q, Chen XP. Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review. World J Clin Cases 2020; 8:4633-4643. [PMID: 33083428 PMCID: PMC7559670 DOI: 10.12998/wjcc.v8.i19.4633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/03/2020] [Accepted: 08/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic lymphangioma, a malformation of the liver lymphatic system, is a rare benign neoplasm and usually coexists with other visceral lymphangiomas. Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy.
CASE SUMMARY A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with, including Schistosome japonicum infection and jaundice, and also together with imaging results, which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase. The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation. Finally, the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation. The pathological examination indicated the mass as hepatic lymphangioma. The patient has been followed up for 30 mo without recurrence. To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future, we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms, imaging presentation, operative techniques, histology features and prognosis.
CONCLUSION Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.
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Affiliation(s)
- Xin Long
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Lei Zhang
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Qi Cheng
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Qian Chen
- Endoscopic Unit, Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
| | - Xiao-Ping Chen
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
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Patil AR, Nandikoor S, De Marco J, Bhat R, Shivakumar S, Mallrajapatna G. Disorders of the lymphatic system of the abdomen. Clin Radiol 2016; 71:941-952. [PMID: 27450410 DOI: 10.1016/j.crad.2016.06.116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/22/2016] [Accepted: 06/27/2016] [Indexed: 12/31/2022]
Abstract
The lymphatic system of the abdomen comprises of the cisterna chyli, its major and minor lymphatic tributaries, and lymph nodes. Disorders of the lymphatic system of the abdomen are rarely encountered and consist of primary and secondary types. Abdominal lymphangiomas constitute the majority and have characteristic imaging features. Complicated lymphangiomas may pose a diagnostic dilemma. Generalised systemic lymphangiomatosis is a rare condition and affects major organs with a poor prognosis. Retroperitoneal lymphangiectasia in the appropriate setting might predict underlying infection, such as filariasis. Other acquired conditions include iatrogenic or treatment-induced chylocoele. Chylous ascites can be secondary to multiple causes and can be confirmed by biochemical testing and lymphangiogram in appropriate settings.
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Affiliation(s)
- A R Patil
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India.
| | - S Nandikoor
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - J De Marco
- Department of Radiology, Morristown Medical Center, Morristown, NJ, USA
| | - R Bhat
- Surgical Gastroenterology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - S Shivakumar
- Pathology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - G Mallrajapatna
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
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Lee HH, Lee SY. Case report of solitary giant hepatic lymphangioma. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2016; 20:71-4. [PMID: 27212994 PMCID: PMC4874048 DOI: 10.14701/kjhbps.2016.20.2.71] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/12/2016] [Accepted: 01/18/2016] [Indexed: 01/16/2023]
Abstract
A hepatic lymphangioma is a rare benign neoplasm that is usually associated with systemic lymphangiomatosis. A solitary hepatic lymphangioma is extremely rare. Therefore, we present a rare case of a female patient who underwent right hepatectomy for solitary giant hepatic lymphangioma. A 42-year-old female presented to the emergency department with complaint of severe abdominal pain of the right upper quadrant. Abdominal computed tomography showed an approximately 23×30-cm sized, giant, relatively well-defined, homogenous cystic mass with few septa in the right liver (segments VII and VIII). The preoperative diagnosis was a giant hepatic cystadenoma or cystadenocarcinoma. We performed right hepatectomy. The permanent histopathological report revealed cystic lymphangioma of the liver. Although the prognosis of solitary hepatic lymphangioma after surgical resection is favorable, recurrence has been reported in literature.
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Affiliation(s)
- Hwan Hyo Lee
- Department of Surgery, Gimpo Woori Hospital, Gimpo, Korea
| | - Seon Youl Lee
- Department of Radiology, Gimpo Woori Hospital, Gimpo, Korea
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Affiliation(s)
- P V Usiakiĭ
- A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russian Federation, Moscow
| | - V A Kubyshkin
- A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russian Federation, Moscow
| | - Iu A Kovalenko
- A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russian Federation, Moscow
| | - D V Kalinin
- A.V. Vishnevsky Institute of Surgery, Ministry of Health of Russian Federation, Moscow
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Nakano T, Hara Y, Shirokawa M, Shioiri S, Goto H, Yasuno M, Tanaka M. Hemorrhagic giant cystic lymphangioma of the liver in an adult female. J Surg Case Rep 2015; 2015:rjv033. [PMID: 25832463 PMCID: PMC4381272 DOI: 10.1093/jscr/rjv033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
An 18-year-old woman who presented with epigastric pain was diagnosed with rupture of a hepatic tumor and transported to our hospital. Contrast-enhanced computed tomography revealed a 13-cm, low-density giant mass in the left hepatic lobe and high-density ascites, indicating abdominal bleeding from the liver tumor. The patient underwent emergent celiac angiography, and the left hepatic artery, which was believed to feed the tumor, was embolized. After the patient's condition stabilized, she underwent left hepatic lobectomy. In addition, the enlarged lymph nodes of the hepatoduodenal ligament were dissected. On microscopic examination, immunohistochemical staining revealed that both the liver cyst and the enlarged lymph node were positive for the endothelial marker CD31 and lymphangial marker D2-40. The patient was pathologically diagnosed with cystic lymphangioma of the liver. She has now been followed up for almost 4 years after surgery without any sign of recurrence.
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Affiliation(s)
- Tomotsugu Nakano
- Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Yoshiaki Hara
- Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Masamitsu Shirokawa
- Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Sadaaki Shioiri
- Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Hideaki Goto
- Department of Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Masamichi Yasuno
- Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Michio Tanaka
- Department of Pathology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
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