1
|
Ferraina F, Fogliati A, Scotti MA, Romano F, Garancini M, Ciulli C. Lobar and Segmental Atrophy of the Liver: Differential Diagnoses and Treatments. LIVERS 2024; 4:320-332. [DOI: 10.3390/livers4030023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2024] Open
Abstract
Segmental or lobar liver atrophy is a common but not well-understood clinical condition. Hepatic atrophy can be classified into hepatic atrophy secondary to other pathologies and primary segmental hepatic atrophy, which is a benign intrahepatic lesion (pseudotumor) not associated with any other pathology. The pathophysiological mechanisms underlying atrophy can be divided into three main situations: obstruction of biliary outflow, obstruction of the systemic venous outflow, and obstruction of incoming portal venous flow. For what may concern secondary hepatic atrophy, there are many pathologies that could underlie this condition, ranging from benign to intrahepatic malignancies, with particular reference to particularly hepatocellular carcinoma and biliary duct carcinoma. An accurate and prompt differential diagnosis between the various forms and causes of atrophy is important for early identification and adequate treatment of underlying pathologies. A comprehensive review of the literature on the etiology and the radiological and histological characteristics of different types of hepatic atrophy is currently unavailable. Therefore, the aim of this review is to summarize the primary and secondary causes of segmental or lobar liver atrophy (excluding forms involving the entire liver parenchyma) and to provide practical tools for clinical and radiological differential diagnosis.
Collapse
Affiliation(s)
- Federica Ferraina
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Alessandro Fogliati
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, Italy
| | - Mauro Alessandro Scotti
- HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, Italy
| | - Fabrizio Romano
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, Italy
| | - Mattia Garancini
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, Italy
| | - Cristina Ciulli
- HPB Surgery Unit, Department of General Surgery, IRCCS San Gerardo dei Tintori Foundation, 20900 Monza, Italy
| |
Collapse
|