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Kitsugi K, Kawata K, Matsumoto M, Umemura M, Hanaoka T, Yamashita M, Takatori S, Ito J, Ohta K, Chida T, Noritake H, Suda T. A Case of Hepatic Angiosarcoma with Peliosis Hepatis. Intern Med 2022; 62:1157-1166. [PMID: 36070948 PMCID: PMC10183276 DOI: 10.2169/internalmedicine.0315-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A 59-year-old woman presented to our hospital with liver dysfunction. Imaging revealed multiple lesions in the liver. The patient was diagnosed with peliosis hepatis using percutaneous and laparoscopic biopsies. However, her condition worsened with the appearance of new, obvious mass-forming lesions. Therefore, she underwent a second percutaneous biopsy of these lesions and was diagnosed with hepatic angiosarcoma. Her condition progressed rapidly, and she died two weeks after the diagnosis. Diagnosis of hepatic angiosarcoma in the early stages is difficult. It should be noted that hepatic angiosarcoma may be associated with the development of peliosis hepatis.
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Affiliation(s)
- Kensuke Kitsugi
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Kazuhito Kawata
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Moe Matsumoto
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Masahiro Umemura
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Tomohiko Hanaoka
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Maho Yamashita
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Shingo Takatori
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Jun Ito
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Kazuyoshi Ohta
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Takeshi Chida
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Hidenao Noritake
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
| | - Takafumi Suda
- Department of Internal Medicine II, Hamamatsu University School of Medicine, Japan
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Keshav N, Ohliger MA. Imaging Vascular Disorders of the Liver. Radiol Clin North Am 2022; 60:857-871. [DOI: 10.1016/j.rcl.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Zhao Y, Liu Y, Zhou L, Zhang XX, Li P, He Q. Clinical experience of liver transplantation in the treatment of peliosis hepatis. Hepatobiliary Pancreat Dis Int 2022; 21:83-85. [PMID: 33814291 DOI: 10.1016/j.hbpd.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 03/08/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Yang Zhao
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China
| | - Yu Liu
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China
| | - Lin Zhou
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China
| | - Xin-Xue Zhang
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China
| | - Ping Li
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China
| | - Qiang He
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital, Capital Medical University, No.8, Gongtinan Road, Chaoyang District, Beijing 100020, China.
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Ren SX, Li PP, Shi HP, Chen JH, Deng ZP, Zhang XE. Imaging presentation and postoperative recurrence of peliosis hepatis: A case report. World J Clin Cases 2021; 9:5197-5202. [PMID: 34307567 PMCID: PMC8283614 DOI: 10.12998/wjcc.v9.i19.5197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/02/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Peliosis hepatis (PH) is a rare benign lesion of vascular origin with a pathological characteristic of multiple blood-filled cavities in the liver parenchyma. It is commonly misdiagnosed due to its lack of specificity in clinical presentation and laboratory test results. Herein, a case of a patient with PH who was misdiagnosed with hepatic echinococcosis before operation to remove the lesions was analyzed, with an emphasis on the computed tomography and magnetic resonance imaging characteristics of PH.
CASE SUMMARY We outline the case of a 40-year-old Chinese female who was admitted with aggravated abdominal pain with fever for 1 wk. Ultrasound examination at the local hospital indicated hepatic echinococcosis. However, discordance between imaging diagnosis, clinical history and laboratory examinations in our hospital. Subsequently, the patient was pathologically confirmed as having PH-like changes, which recurred 1 year after operation removal of the lesion.
CONCLUSION Our objective is to highlight the imaging diagnostic value of PH.
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Affiliation(s)
- Si-Xie Ren
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Pan-Pan Li
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Hai-Peng Shi
- Pathology Center, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Jun-Hui Chen
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Zhen-Ping Deng
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
| | - Xi-E Zhang
- Department of Radiology, Chengdu Second People’s Hospital, Chengdu 610000, Sichuan Province, China
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Slouma M, Khrifech Y, Dhahri R, Hannech E, Tayeb Z, Ghozzi A, Metoui L, Gharsallah I, Louzir B. Psoriatic arthritis associated with peliosis hepatis: characteristics and therapeutic management. Clin Rheumatol 2021; 40:3827-3832. [PMID: 33598810 DOI: 10.1007/s10067-021-05647-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 11/30/2022]
Abstract
Peliosis hepatis is characterized by hepatic sinusoidal dilatation and multiple blood-filled cystic cavities within the liver parenchyma. It can be due to infectious diseases, immunological disorders, neoplasia, and the use of various kinds of drugs. We presented the case of a nonsmoker 55-year-old man who complained about a 5-month history of arthritis. Medical history was consistent with psoriasis and hypertension. He denied any drug use or alcohol consumption. Physical examination showed extended psoriatic lesions. He had arthritis of the knees, ankles, wrists, and elbows. His body mass index was 22 kg/m2. Laboratory findings revealed an increased serum gamma-glutamyl transferase level (1014 UI/L, normal value (N) 11-55) and total alkaline phosphatase (278 U/L, N 30-171). Hepatitis A, B, and C serologic test results were negative. Anti-nuclear antibodies, anti-Ro/SSA, anti-GP210, anti-SP100, anti-SLA, anti-LKM1, anti-M2, anti-LC1, and anti-PML were also negative. Histopathological examination of a liver biopsy specimen revealed peliosis hepatis.The pelvic radiograph showed bilateral ankylosis of sacroiliac joints. Hand and foot radiographs showed periosteal bone apposition. The diagnosis of psoriatic arthritis associated with peliosis hepatis was made. The patient received infliximab (5 mg/kg) with a significant improvement after 3 months of follow-up. Peliosis hepatis should be considered as a possible etiology of liver enzyme abnormalities in patients with psoriatic arthritis. We highlighted the effectiveness and safety of the TNF inhibitors in the treatment of peliosis hepatis associated with psoriatic arthritis. Key Points • Peliosis hepatis should be considered as a possible etiology of liver enzyme disturbance in patients with psoriatic arthritis. • Special caution should be advised in the management of psoriatic arthritis associated with peliosis hepatis to avoid the worsening of liver function. • Infliximab is suggested as a possible treatment of peliosis hepatis associated with psoriatic arthritis.
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Affiliation(s)
- Maroua Slouma
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia. .,University of Tunis El Manar, Tunis, Tunisia.
| | - Yasmine Khrifech
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Rim Dhahri
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Emna Hannech
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Zeineb Tayeb
- University of Tunis El Manar, Tunis, Tunisia.,Department of Internal Medicine, Internal Security Forces Hospital, Tunis, Tunisia
| | - Amen Ghozzi
- University of Tunis El Manar, Tunis, Tunisia.,Department of Pathology, Internal Security Forces Hospital, Tunis, Tunisia
| | - Leila Metoui
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Imen Gharsallah
- Department of Rheumatology, Military Hospital, 1007, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Bassem Louzir
- University of Tunis El Manar, Tunis, Tunisia.,Department of Internal Medicine, Military Hospital, Tunis, Tunisia
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Angulo E, Joyner S, Majeed NK, Nyenhuis S. A rare case of peliosis hepatis in primary immune deficiency. SAGE Open Med Case Rep 2020; 8:2050313X20931996. [PMID: 32595972 PMCID: PMC7301656 DOI: 10.1177/2050313x20931996] [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: 02/07/2019] [Accepted: 05/13/2020] [Indexed: 12/02/2022] Open
Abstract
Peliosis hepatis is a rare condition characterized by blackish-blue blood-filled cavities in hepatic parenchyma caused by dilatation of hepatic sinusoids. Peliosis hepatis has been described in secondary immunodeficiencies and certain medications. We present the first case of peliosis hepatis in a patient with a primary immunodeficiency, common variable immunodeficiency. A 44-year-old African-American male presented with gastrointestinal bleeding and elevated liver function tests. His medical history included common variable immunodeficiency and chronic kidney disease. The patient had jaundice, regenerative nodules on liver pathology, and low immunoglobulin levels. A magnetic resonance imaging of the abdomen with contrast revealed a cirrhotic liver, a 5 × 3 cm lesion, and poorly defined nodules which had decreased enhancement. A computed tomography-guided liver biopsy revealed peliosis hepatis, focal nodular hyperplasia, and fibrosis. No other etiology of his liver disease was found. The etiology of peliosis hepatis in patients with primary immunodeficiencies remains unclear. Additional studies are needed to understand the underlying mechanisms.
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Affiliation(s)
- Evelyn Angulo
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Sydney Joyner
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Nasma K Majeed
- Department of Pathology, University of Illinois at Chicago, Chicago, IL, USA
| | - Sharmilee Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Abstract
RATIONALE Peliosis hepatis (PH), which is characterized by blood-filled cavities in the liver, is a rare disease. Its diagnosis depends on postoperative pathological examinations and immunohistochemistry. PATIENT CONCERNS A 44-year-old female complained of right-middle upper abdominal pain and distension for 1 month, with occasional vomiting and fever. DIAGNOSIS Because of the similar imaging features, the patient was initially misdiagnosed as cystic echinococcosis (CE). The immunoassay of echinococcosis was negative. Irregular hepatectomy was performed. Eventually, the patient was diagnosed with PH based on postoperative histopathology and immunohistochemistry. INTERVENTIONS The patient underwent hepatectomy. Then, the cystic lesion was collected for intraoperative pathological examination. Thus, the blood liquid was extracted from the cystic lesion. Pringle maneuver was administered to prevent bleeding, and then the whole cystic lesion was removed. OUTCOMES She recovered smoothly and there was no relapse occurred during 6 months' follow-up. LESSONS It is difficult to differentiate PH from CE and other hepatic diseases due to the lack of special imaging features. Pathological examinations and immunohistochemistry can provide a confirmed diagnosis of PH.
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Affiliation(s)
- JinHeng Liu
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu
- Department of Hepatobiliary-Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - YanTin Wang
- Department of Hepatobiliary-Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - SiNeng Yin
- Department of Hepatobiliary-Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - NengWen Ke
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu
| | - XuBao Liu
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu
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Abstract
A 20-year-old man with gastrointestinal symptoms and weight loss underwent FDG PET/CT, which revealed multiple hypermetabolic hepatic lesions concerning for metastatic liver disease. The outcome of liver biopsy was consistent with the diagnosis of peliosis hepatis which is a rare benign disease characterized by multiple blood-filled cystic spaces in the hepatic parenchyma. The findings of peliosis on FDG PET/CT are not well reported in the literature. These interesting images emphasize the importance of including peliosis hepatis in the differential diagnosis of multiple hypermetabolic hepatic lesions on FDG PET/CT, which could simulate malignancy.
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Liver and Bile Duct Infections. DIAGNOSTIC PATHOLOGY OF INFECTIOUS DISEASE 2018. [PMCID: PMC7152297 DOI: 10.1016/b978-0-323-44585-6.00011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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10
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Dai YN, Ren ZZ, Song WY, Huang HJ, Yang DH, Wang MS, Huang YC, Chen MJ, Zhang JJ, Tong YX, Pan HY. Peliosis hepatis: 2 case reports of a rare liver disorder and its differential diagnosis. Medicine (Baltimore) 2017; 96:e6471. [PMID: 28353584 PMCID: PMC5380268 DOI: 10.1097/md.0000000000006471] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
RATIONALE Peliosis hepatis (PH) is a rare tumor-like liver lesion composed of multiple blood-filled cavities within the liver parenchyma. It is hard to differentiate PH from other liver lesions by imaging, such as carcinoma, metastases, or abscess. PATIENT CONCERNS Here, we reported 2 cases that presented with liver lesions under ultrasound and computed tomography (CT) scanning, without any history of liver diseases or drug usage traced back. DIAGNOSES Liver biopsy and laparoscopy were processed, and the lesions were eventually diagnosed as PH by histopathology, which microscopically presented with multiple sinusoidal dilatations with blood-filled cystic spaces. INTERVENTIONS After the liver biopsy or laparoscopy, the patients were discharged and followed up in the clinic. OUTCOMES Both patients were followed up for at least 1 year with good recovery. LESSONS PH should always be recognized in the differentiation of liver lesions, particularly indistinctive lesion(s) without any history of liver-related diseases.
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Affiliation(s)
- Yi-Ning Dai
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Ze-Ze Ren
- Department of Infectious Diseases, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang, China
| | - Wen-Yuan Song
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Hai-Jun Huang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Dan-Hong Yang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Ming-Shan Wang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Yi-Cheng Huang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Mei-Juan Chen
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Jia-Jie Zhang
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Yong-Xi Tong
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
| | - Hong-Ying Pan
- Department of Infectious Diseases, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College
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Kim SB, Kim DK, Byun SJ, Park JH, Choi JY, Park YN, Kim DY. Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura. Clin Mol Hepatol 2015; 21:387-92. [PMID: 26770928 PMCID: PMC4712167 DOI: 10.3350/cmh.2015.21.4.387] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/18/2014] [Accepted: 04/01/2014] [Indexed: 12/20/2022] Open
Abstract
Peliosis hepatis is a rare condition that can cause hepatic hemorrhage, rupture, and ultimately liver failure. Several authors have reported that peliosis hepatis develops in association with chronic wasting disease or prolonged use of anabolic steroids or oral contraceptives. In this report we describe a case in which discontinuation of steroid therapy improved the condition of a patient with peliosis hepatis. Our patient was a 64-year-old woman with a history of long-term steroid treatment for idiopathic thrombocytopenic purpura . Her symptoms included abdominal pain and weight loss; the only finding of a physical examination was hepatomegaly. We performed computed tomography (CT) and magnetic resonance imaging (MRI) of the liver and a liver biopsy. Based on these findings plus clinical observations, she was diagnosed with peliosis hepatis and her steroid treatment was terminated. The patient recovered completely 3 months after steroid discontinuation, and remained stable over the following 6 months.
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Affiliation(s)
- Sun Bean Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Do Kyung Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Jeong Byun
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hye Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Young Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Nyun Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.; Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea
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Crocetti D, Palmieri A, Pedullà G, Pasta V, D’Orazi V, Grazi GL. Peliosis hepatis: Personal experience and literature review. World J Gastroenterol 2015; 21:13188-13194. [PMID: 26675327 PMCID: PMC4674738 DOI: 10.3748/wjg.v21.i46.13188] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 05/22/2015] [Accepted: 08/31/2015] [Indexed: 02/06/2023] Open
Abstract
Peliosis hepatis (PH) is a disease characterized by multiple and small, blood-filled cysts within the parenchymatous organs. PH is a very rare disease, more common in adults, and when it affects the liver, it comes to the surgeon’s attention only in an extremely urgent situation after the lesion’s rupture with the resulting hemoperitoneum. This report describes the case of a 29-year-old woman affected by recurring abdominal pain. Computed tomography scans showed a hepatic lesion formed by multiple hypodense areas, which showed an early acquisition of the contrast during the arterial phase. Furthermore, it remained isodense with the remaining parenchyma during the late venous phase. We decided on performing a liver resection of segment VII while avoiding a biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal PH. PH should always be considered in the differential diagnosis of hepatic lesions. Clinicians should discuss the possible causes and issues related to the differential diagnosis in addition to the appropriate therapeutic approach. The fortuitous finding of a lesion, potentially compatible with PH, requires elective surgery with diagnostic and therapeutic intents. The main aim is to prevent the risk of a sudden bleeding that, in absence of properly equipped structures, may have a fatal outcome.
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Seo M, Lee SH, Han S, Sung C, Son DH, Lee JJ. Peliosis Hepatis Shows Isometabolism on (18)F-FDG PET/CT: Two Case Reports. Nucl Med Mol Imaging 2014; 48:309-12. [PMID: 26396637 DOI: 10.1007/s13139-014-0281-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 05/19/2014] [Indexed: 01/07/2023] Open
Abstract
Peliosis hepatis (PH) is a rare benign disease that is characterized by multiple blood-filled cystic spaces in the hepatic parenchyma. It is also characterized by a range of radiologic findings that might mimic various diseases, including metastatic liver disease and hepatocellular carcinoma. The findings of PH on (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) are not well reported. We here report two cases of biopsy-proven PH. Both patients had been treated for cancer (advanced gastric carcinoma and rectal adenocarcinoma), and follow-up CT of both cases revealed hepatic lesions with the possibility of metastasis. Examination of (18)F-FDG PET/CT images suggested that the lesions were isometabolic, having metabolism similar to that of adjacent hepatic parenchyma. The outcomes of hepatic core-needle biopsies were consistent with peliosis hepatis.
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Affiliation(s)
- Minjung Seo
- Departments of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736 South Korea
| | - Suk Hyun Lee
- Departments of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736 South Korea
| | - Sangwon Han
- Departments of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736 South Korea
| | - Changhwan Sung
- Departments of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736 South Korea
| | - Da Hye Son
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jong Jin Lee
- Departments of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 138-736 South Korea
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Fortún J, Martín-Dávila P, Gómez-Mampaso E, Vallejo A, Cuartero C, González-García A, Rubí J, Pallarés E, Moreno S. Extra-pulmonary tuberculosis: a biomarker analysis. Infection 2014; 42:649-54. [PMID: 24652106 DOI: 10.1007/s15010-014-0602-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 02/14/2014] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Studies on biomarkers in tuberculosis are focused on pulmonary forms of this disease (PTB), and only limited information is currently available on biomarkers of extra-pulmonary tuberculosis (EPTB). METHODS Serum samples from 24 patients with PTB, 29 patients with EPTB and 27 healthy controls were obtained, and the levels of interferon-gamma, chemokine ligand 9, mannose-binding lectin (MBL), tumor marker Ca-125 and adenosine deaminase were determined. RESULTS The circulating levels of all tested biomarkers in the serum were significantly higher in PTB and EPTB patients than in controls. However, there were no significant differences in the levels of the biomarkers between patients with PTB and EPTB, with the exception of serum levels of MBL which were significantly higher in patients with EPTB than in patients with PTB (p = 0.01). In patients with EPTB, no significant differences were observed in biomarker levels among patients with or without concomitant PTB involvement. Based on MBL serum levels, ROC curve analysis showed an AUC of 0.85 for EPTB versus non-EPTB. The optimal cut-off value of MBL serum levels for EPTB versus non-EPTB was 1,000 μg/ml, with a sensitivity and specificity of 79.3 and 78.0 %, respectively. CONCLUSIONS Biomarkers usually present as acute phase reactants and do not enable pulmonary forms to be differentiated from more serious or extra-pulmonary forms. MBL may be an exception.
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Affiliation(s)
- J Fortún
- Infectious Diseases Department, Ramon y Cajal Hospital, Ctra Colmenar km 9.1, 28034, Madrid, Spain,
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