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Review
. 2012 Nov 7;18(41):5999-6002.
doi: 10.3748/wjg.v18.i41.5999.

Focal peliosis hepatis in a colon cancer patient resembling metastatic liver tumor

Wu-Jun Xiong  1 , Li-Juan Hu, Yi-Cheng Jian, Yi He, Wei Zhou, Xin-Lai Guo, Ya-Xin Zheng
Affiliations
Review

Focal peliosis hepatis in a colon cancer patient resembling metastatic liver tumor

Wu-Jun Xiong et al. World J Gastroenterol. .

Abstract

Peliosis hepatis (PH) is a rare benign condition characterized by the presence of multiple, randomly distributed, blood filled cystic areas of variable size within the liver parenchyma. PH is difficult to recognize and may be mistaken for neoplasm, metastases or multiple abscesses. A 75-year-old female with a previous history of colon cancer was admitted when a liver mass in the right liver lobe was found 11 mo after surgery during the follow-up period. Computed tomography and magnetic resonance imaging scan of the abdomen were performed. The initial possible diagnosis was metastatic hepatocellular carcinoma. The patient underwent excision of the hepatic segment where the nodule was located. The pathological diagnosis of the surgical specimen was PH. PH should be considered in the differential diagnosis of new liver lesions in patients whose clinical settings do not clearly favor metastasization. Clinicians and radiologists must recognize these lesions to minimize the probability of misdiagnosis and inappropriate treatment.

Keywords: Differential diagnosis; Metastatic liver tumor; Peliosis hepatis.

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Figures

Figure 1
Figure 1
Positron emission tomography plus computed tomography and computed tomography scan findings in our patient. A: Positron emission tomography plus computed tomography (PET/CT) scan showed thickening of the ileocecal region (white arrow), and no liver lesions; B: PET/CT scan showed increased metabolic areas in the ileocecal region (white arrow), no increased metabolic areas in the liver; C: Six months later a follow-up CT scan showed no liver lesions; D: Eleven months later a follow-up CT scan showed one low-density lesion in the right liver lobe (white arrow).
Figure 2
Figure 2
Magnetic resonance imaging scan findings in our patient. A: On T1-weighted images, the hepatic lesion shows low signal intensity; B: On T2-weighted images, the lesion shows hyperintense signal intensity; C: In the arterial phase, the lesion remains unenhanced; D, E: During the portal and delayed phases, the lesion displays peripheral enhancement with a centripetal progression. L: Left; A: Ahead.
Figure 3
Figure 3
Photomicrograph of a liver section from our case showing variable-sized, blood-filled cystic spaces (hematoxylin and eosin, 200 ×).
See this image and copyright information in PMC

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