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Case Reports
. 2024 Mar 11;18(1):100.
doi: 10.1186/s13256-024-04399-1.

Computed tomography angiography of liver alveococcosis: a case report

Saodatkhon Magzumova  1 , Umidjon Isroilov  2 , Nigora Djuraeva  3 , Zarina Khaybullina  4 , Aybek Amirkhamzaev  2 , Nargiza Vakhidova  2 , Khanum Abdukhalimova  2 , Alisher Sultanov  2 , Bekhzod Abdullaev  2   5
Affiliations
Case Reports

Computed tomography angiography of liver alveococcosis: a case report

Saodatkhon Magzumova et al. J Med Case Rep. .

Abstract

Background: Alveococcosis, helminthiasis caused by the larvae of Alveococcus multilocularis, is characterized by the formation of parasitic nodes in the liver. This clinical case is a rare occurrence of liver alveococcosis in Uzbekistan.

Case presentation: We present a case of a 33-year-old Asian woman from Uzbekistan who complained of discomfort in the epigastric region and right hypochondrium, along with general weakness. She had been experiencing symptoms for 5 months when a routine ultrasound examination revealed a structural formation in the liver. Patient was investigated by using contrast enhanced computed tomography (CT) and diagnosed with liver alveococcosis with multiple lesions. Patient underwent diagnostic laparotomy with obtaining gross specimen, biomaterial was examined microscopically and found that there were small fragments of fibrous tissue determined together with small groups of cystic formations and walls consisted of chitin. Moreover, contrast enhanced CT allowed us to differentiate liver alveococcosis from cavernous hemangioma, hepatocellular carcinoma, and liver metastases from unknown source.

Conclusion: Contrast enhanced CT plays a major role in differentially diagnosing liver alveococcosis and makes it the first line method of choice for the consideration of the future treatment and surgical interventions.

Keywords: Contrast enhanced computed tomography; Cystic formation; Liver alveococcosis; Liver lesions.

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Conflict of interest statement

The authors declare that there is no competing interests.

Figures

Fig. 1
Fig. 1
Coronal (a) and axial (b) CT image in the native phase demonstrates tumor masses in IV, VIII and partially V, VI segments. Uneven fuzzy contours, signs of infiltrative growth into the liver parenchyma, cystic-solid structure with + 10 to + 40 HU, single calcified inclusions (+ 145HU), invasion into the Glisson’s capsule, dilatation of the bile ducts along the tumor periphery
Fig. 2
Fig. 2
Contrast-enhanced coronal (a) and axial (b) CT images show in arterial phase there is a moderate accumulation of contrast agent in the solid part density up to + 45 to + 55 HU
Fig. 3
Fig. 3
a, b. In the venous phase: continued moderate accumulation of contrast agent in the solid part of the formation density up to + 45 to + 65 HU
Fig. 4
Fig. 4
a, b. Delayed phase—preservation of CV in the solid part of the formation—density up to + 40 to + 60 HU
Fig. 5
Fig. 5
a, b after diagnostic laparotomy, histologic examination was carried out. Diagnostic laparotomy was done on February 13, 2019. Histologic investigation of the gross specimen showed that small fragments of fibrous tissue was determined together with small groups of cystic formations and walls consisted of chitin. Diagnosis: Chitinous membrane of alveococcocus
See this image and copyright information in PMC

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