2015, Number 4
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Ann Hepatol 2015; 14 (4)
Multiple liver lesions in a patient with Budd-Chiari syndrome secondary to polycythemia vera
Putra J, Toor A, Noce TA, Thung SN, Suriawinata AA, Lisovsky M
Language: English
References: 8
Page: 547-549
PDF size: 195.81 Kb.
ABSTRACT
Focal nodular hyperplasia and nodular regenerative hyperplasia are occasionally seen in patients with hepatic
venous outflow obstruction as a consequence of circulatory stress in the liver. In addition, neoplastic
processes such as hepatic adenoma, hepatocellular carcinoma, and metastatic disease may arise in
these patients. Histologic evaluation is necessary when imaging modalities are unable to distinguish these
lesions. We present a case of multiple hepatic lesions, suspicious for metastases, in a patient with Budd-
Chiari syndrome secondary to polycythemia vera. However, the biopsy findings were consistent with focal
nodular hyperplasia. Budd-Chiari syndrome may be associated with multiple nodules of focal nodular hyperplasia,
which may be difficult to diagnose radiologically.
REFERENCES
Bioulac-Sage P, Cubel G, Taouji S, Scoazec J, Leteurtre E, Paradis V, Sturm N, et al. Immunohistochemical markers on needle biopsies are helpful for the diagnosis of focal nodular hyperplasia and hepatocellular adenoma subtypes. Am J Surg Pathol 2012; 36: 1691-9.
Pavri TM, Herbst A, Reddy R, Forde KA. Budd-Chiari syndrome: a single-center experience. World J Gastroenterol 2014; 20: 16236-44.
Tanaka M, Wanless IR. Pathology of the liver in Budd- Chiari syndrome: portal vein thrombosis and the histopathogenesis of veino-centric cirrhosis, veno-portal cirrhosis, and large regenerative nodules. Hepatology 1998; 27: 488-96.
Ibarrola C, Castellano VM, Colina F. Focal hyperplastic hepatocellular nodules in hepatic venous outflow obstruction: a clinicopathological study of four patients and 24 nodules. Histopathology 2004; 44: 172-9.
Maetani Y, Itoh K, Egawa H, Haga H, Sakurai T, Nishida N, Ametani F, et al. Benign hepatic nodules in Budd-Chiari syndrome: radiologic-pathologic correlation with emphasis on the central scar. AJR Am J Roentgenol 2002; 178: 869-75.
Leyendecker JR. Gadoxenate disodium for contrast magnetic resonance imaging of the liver. Gastroenterol Hepatol (NY) 2009; 5: 698.
Albiin N. MRI of focal liver lesions. Curr Med Imaging Rev 2012; 8: 107-16.
Choi JY, Lee HC, Yim JH, Shim JH, Lim YS, Shin YM, Yu ES, et al. Focal nodular hyperplasia or focal nodular hyperplasia- like lesions of the liver: a special emphasis on diagnosis. J Gastroenterol Hepatol 2011; 26: 1004-9.