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Imaging of multifocal liver lesions in children and adolescents.

Hegde SV, Dillman JR, Lopez MJ, Strouse PJ - Cancer Imaging (2013)

Bottom Line: Multifocal liver lesions are encountered regularly in children and adolescents.By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis.The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

ABSTRACT
Multifocal liver lesions are encountered regularly in children and adolescents. By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis. The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

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A 16-year-old girl with Turner syndrome, chronic portal vein occlusion, and multiple hepatocellular adenomas. (a) Composite longitudinal and transverse greyscale ultrasound images show an echogenic mass (arrows) in the posterior segment of the right hepatic lobe with circumscribed lobular margins. (b,c) Axial T1-weighted GRE in-phase and out-of-phase images demonstrate signal loss within the lesion (arrows) on out-of-phase imaging due to the presence of intracellular lipid. Percutaneous needle biopsy of several liver lesions confirmed the diagnosis of multiple hepatocellular adenomas. An additional mass (arrowheads) immediately adjacent to the presented hepatocellular adenoma was histopathologically confirmed to be a benign regenerative nodule.
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Figure 4: A 16-year-old girl with Turner syndrome, chronic portal vein occlusion, and multiple hepatocellular adenomas. (a) Composite longitudinal and transverse greyscale ultrasound images show an echogenic mass (arrows) in the posterior segment of the right hepatic lobe with circumscribed lobular margins. (b,c) Axial T1-weighted GRE in-phase and out-of-phase images demonstrate signal loss within the lesion (arrows) on out-of-phase imaging due to the presence of intracellular lipid. Percutaneous needle biopsy of several liver lesions confirmed the diagnosis of multiple hepatocellular adenomas. An additional mass (arrowheads) immediately adjacent to the presented hepatocellular adenoma was histopathologically confirmed to be a benign regenerative nodule.

Mentions: Hepatocellular adenoma is an uncommon liver tumor during childhood that is composed of sheets of vacuolated hepatocytes with intervening dilated sinusoids, a reduced number of Kupffer cells (compared with normal liver), and no bile ducts[1]. Development of hepatocellular adenomas has been associated with oral contraceptive use in girls, anabolic steroid use in boys, glycogen storage disease, and congenital/acquired abnormalities of hepatic vasculature (Fig. 4)[1]. About 20% of patients with hepatocellular adenomas have multiple lesions, particularly in the setting of predisposing conditions, such as those mentioned above[1]. Hepatocellular adenomas may be complicated by rupture with potentially life-threatening hemoperitoneum and malignant degeneration[5].Figure 4


Imaging of multifocal liver lesions in children and adolescents.

Hegde SV, Dillman JR, Lopez MJ, Strouse PJ - Cancer Imaging (2013)

A 16-year-old girl with Turner syndrome, chronic portal vein occlusion, and multiple hepatocellular adenomas. (a) Composite longitudinal and transverse greyscale ultrasound images show an echogenic mass (arrows) in the posterior segment of the right hepatic lobe with circumscribed lobular margins. (b,c) Axial T1-weighted GRE in-phase and out-of-phase images demonstrate signal loss within the lesion (arrows) on out-of-phase imaging due to the presence of intracellular lipid. Percutaneous needle biopsy of several liver lesions confirmed the diagnosis of multiple hepatocellular adenomas. An additional mass (arrowheads) immediately adjacent to the presented hepatocellular adenoma was histopathologically confirmed to be a benign regenerative nodule.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569672&req=5

Figure 4: A 16-year-old girl with Turner syndrome, chronic portal vein occlusion, and multiple hepatocellular adenomas. (a) Composite longitudinal and transverse greyscale ultrasound images show an echogenic mass (arrows) in the posterior segment of the right hepatic lobe with circumscribed lobular margins. (b,c) Axial T1-weighted GRE in-phase and out-of-phase images demonstrate signal loss within the lesion (arrows) on out-of-phase imaging due to the presence of intracellular lipid. Percutaneous needle biopsy of several liver lesions confirmed the diagnosis of multiple hepatocellular adenomas. An additional mass (arrowheads) immediately adjacent to the presented hepatocellular adenoma was histopathologically confirmed to be a benign regenerative nodule.
Mentions: Hepatocellular adenoma is an uncommon liver tumor during childhood that is composed of sheets of vacuolated hepatocytes with intervening dilated sinusoids, a reduced number of Kupffer cells (compared with normal liver), and no bile ducts[1]. Development of hepatocellular adenomas has been associated with oral contraceptive use in girls, anabolic steroid use in boys, glycogen storage disease, and congenital/acquired abnormalities of hepatic vasculature (Fig. 4)[1]. About 20% of patients with hepatocellular adenomas have multiple lesions, particularly in the setting of predisposing conditions, such as those mentioned above[1]. Hepatocellular adenomas may be complicated by rupture with potentially life-threatening hemoperitoneum and malignant degeneration[5].Figure 4

Bottom Line: Multifocal liver lesions are encountered regularly in children and adolescents.By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis.The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

View Article: PubMed Central - PubMed

Affiliation: Section of Pediatric Radiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, USA.

ABSTRACT
Multifocal liver lesions are encountered regularly in children and adolescents. By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis. The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

Show MeSH
Related in: MedlinePlus