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Radiological spectrum of hepatic mesenchymal hamartoma in children.

Kim SH, Kim WS, Cheon JE, Yoon HK, Kang GH, Kim IO, Yeon KM - Korean J Radiol (2007 Nov-Dec)

Bottom Line: On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US.On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement.The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: A hepatic mesenchymal hamartoma is an uncommon benign tumor in children and little is known about the spectrum of its radiological features. The purpose of this study is to describe the spectrum of radiological features of a hepatic mesenchymal hamartoma in children.

Materials and methods: Thirteen children with a pathologically confirmed hepatic mesenchymal hamartoma (M:F = 7:6; mean age, 3 years 2 months) were included in our study. Ultrasonography (US) was performed in nine patients including color and power Doppler US (n = 7). CT scans were performed in all patients. We evaluated the imaging findings of the hepatic mesenchymal hamartomas and the corresponding pathological features.

Results: Each patient had a single tumor (mean diameter: 13 cm [1.8-20 cm]). On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US. On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement. The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042).

Conclusion: A hepatic mesenchymal hamartoma in children can show a wide spectrum of radiological features, from a multiseptated cystic tumor to a mixed solid and cystic tumor, and even a solid tumor.

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Related in: MedlinePlus

A mesenchymal hamartoma in a 7-year-2-month-old boy (case 7).A. US shows a huge, mixed solid and cystic tumor. The echogenic materials and fluid-fluid levels (arrows) are noted in the cystic portions of the tumor. The solid portion of the tumor is hyperechoic (*).B. Color Doppler US shows vascularity along the thick septa and solid portion of the tumor.C. A pre-contrast CT scan shows a low attenuating tumor in the right lobe of the liver. Note the fluid-fluid levels due to an intracystic hemorrhage within some of the cystic areas (arrows).D. On a post-contrast CT scan, the solid portion of the tumor shows heterogeneous enhancement (arrows).E, F. A photograph of a cut section of the specimen shows a large tumor with a central solid portion and a peripheral cystic portion (arrows, E). The solid portion contains a large amount of myxoid mesenchymal stroma and proliferation of the bile duct, as seen on the photomicrograph (F, Hematoxylin & Eosin staining, × 40).
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Figure 2: A mesenchymal hamartoma in a 7-year-2-month-old boy (case 7).A. US shows a huge, mixed solid and cystic tumor. The echogenic materials and fluid-fluid levels (arrows) are noted in the cystic portions of the tumor. The solid portion of the tumor is hyperechoic (*).B. Color Doppler US shows vascularity along the thick septa and solid portion of the tumor.C. A pre-contrast CT scan shows a low attenuating tumor in the right lobe of the liver. Note the fluid-fluid levels due to an intracystic hemorrhage within some of the cystic areas (arrows).D. On a post-contrast CT scan, the solid portion of the tumor shows heterogeneous enhancement (arrows).E, F. A photograph of a cut section of the specimen shows a large tumor with a central solid portion and a peripheral cystic portion (arrows, E). The solid portion contains a large amount of myxoid mesenchymal stroma and proliferation of the bile duct, as seen on the photomicrograph (F, Hematoxylin & Eosin staining, × 40).

Mentions: The longest diameter of the tumors ranged from 1.8 to 20 cm (mean 13.0 cm) and was larger than 10 cm in 11 patients (85%). There was no significant difference in the size of the tumors (p = 0.79) among the three CT types of tumors. The tumor was multiseptated cystic in four patients (31%) (Fig. 1), mixed solid and cystic in five patients (38%) (Figs. 2, 3), and solid in four patients (31%) (Figs. 4, 5).


Radiological spectrum of hepatic mesenchymal hamartoma in children.

Kim SH, Kim WS, Cheon JE, Yoon HK, Kang GH, Kim IO, Yeon KM - Korean J Radiol (2007 Nov-Dec)

A mesenchymal hamartoma in a 7-year-2-month-old boy (case 7).A. US shows a huge, mixed solid and cystic tumor. The echogenic materials and fluid-fluid levels (arrows) are noted in the cystic portions of the tumor. The solid portion of the tumor is hyperechoic (*).B. Color Doppler US shows vascularity along the thick septa and solid portion of the tumor.C. A pre-contrast CT scan shows a low attenuating tumor in the right lobe of the liver. Note the fluid-fluid levels due to an intracystic hemorrhage within some of the cystic areas (arrows).D. On a post-contrast CT scan, the solid portion of the tumor shows heterogeneous enhancement (arrows).E, F. A photograph of a cut section of the specimen shows a large tumor with a central solid portion and a peripheral cystic portion (arrows, E). The solid portion contains a large amount of myxoid mesenchymal stroma and proliferation of the bile duct, as seen on the photomicrograph (F, Hematoxylin & Eosin staining, × 40).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627452&req=5

Figure 2: A mesenchymal hamartoma in a 7-year-2-month-old boy (case 7).A. US shows a huge, mixed solid and cystic tumor. The echogenic materials and fluid-fluid levels (arrows) are noted in the cystic portions of the tumor. The solid portion of the tumor is hyperechoic (*).B. Color Doppler US shows vascularity along the thick septa and solid portion of the tumor.C. A pre-contrast CT scan shows a low attenuating tumor in the right lobe of the liver. Note the fluid-fluid levels due to an intracystic hemorrhage within some of the cystic areas (arrows).D. On a post-contrast CT scan, the solid portion of the tumor shows heterogeneous enhancement (arrows).E, F. A photograph of a cut section of the specimen shows a large tumor with a central solid portion and a peripheral cystic portion (arrows, E). The solid portion contains a large amount of myxoid mesenchymal stroma and proliferation of the bile duct, as seen on the photomicrograph (F, Hematoxylin & Eosin staining, × 40).
Mentions: The longest diameter of the tumors ranged from 1.8 to 20 cm (mean 13.0 cm) and was larger than 10 cm in 11 patients (85%). There was no significant difference in the size of the tumors (p = 0.79) among the three CT types of tumors. The tumor was multiseptated cystic in four patients (31%) (Fig. 1), mixed solid and cystic in five patients (38%) (Figs. 2, 3), and solid in four patients (31%) (Figs. 4, 5).

Bottom Line: On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US.On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement.The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

Objective: A hepatic mesenchymal hamartoma is an uncommon benign tumor in children and little is known about the spectrum of its radiological features. The purpose of this study is to describe the spectrum of radiological features of a hepatic mesenchymal hamartoma in children.

Materials and methods: Thirteen children with a pathologically confirmed hepatic mesenchymal hamartoma (M:F = 7:6; mean age, 3 years 2 months) were included in our study. Ultrasonography (US) was performed in nine patients including color and power Doppler US (n = 7). CT scans were performed in all patients. We evaluated the imaging findings of the hepatic mesenchymal hamartomas and the corresponding pathological features.

Results: Each patient had a single tumor (mean diameter: 13 cm [1.8-20 cm]). On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US. On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement. The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042).

Conclusion: A hepatic mesenchymal hamartoma in children can show a wide spectrum of radiological features, from a multiseptated cystic tumor to a mixed solid and cystic tumor, and even a solid tumor.

Show MeSH
Related in: MedlinePlus