Hepatic amyloidosis
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At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures- Liver amyloidosis
- Amyoidosis of the liver
- Amyoidosis involving the liver
Hepatic amyloidosis refers to the extracellular deposition of amyloid in the parenchyma sinusoids or vessel walls. Liver involvement in amyloidosis is uncommon.
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Pathology
It can be primary or secondary and it typically occurs as diffuse infiltration 2.
There is amyloid deposition in liver parenchyma which occurs along the sinusoids within the space of Disse, or in blood vessel walls. Hepatocytes can be markedly compressed by extensive accumulation of amyloid and they may atrophy or nearly disappear.
In advanced cases with massive infiltration, the liver is enlarged with a rubbery elastic consistency, and it may show 'lardaceous liver' appearance.
Radiographic features
Hepatomegaly and heterogeneous appearances of the liver parenchyma are the most common, though nonspecific, imaging features 7.
Ultrasound
Non-specific and may show heterogeneous hepatic echotexture 3 or diffuse or focal areas of low attenuation 7. Prominent calcifications can be rarely seen.
CT
There can be hepatomegaly with decreased hepatic attenuation 2. Some calcification may be present.
MRI
- T1: has increased signal through the liver 1,3
- T2: little change 3
Differential diagnosis
For CT appearances of decreased hepatic attenuation: see causes of decreased hepatic attenuation.
References
- 1. Shin Y. Hepatic Amyloidosis. Korean J Hepatol. 2011;17(1):80. doi:10.3350/kjhep.2011.17.1.80
- 2. Georgiades C, Neyman E, Barish M, Fishman E. Amyloidosis: Review and CT Manifestations. Radiographics. 2004;24(2):405-16. doi:10.1148/rg.242035114
- 3. Son R, Chang J, Choi J. Primary Hepatic Amyloidosis: Report of an Unusual Case Presenting as a Mass. Korean J Radiol. 2011;12(3):382. doi:10.3348/kjr.2011.12.3.382
- 4. MØller J, Santoni-Rugiu E, Chabanova E, Løgager V, Hansen A, Thomsen H. Magnetic Resonance Imaging with Liver-Specific Contrast Agent in Primary Amyloidosis and Intrahepatic Cholestasis. Acta Radiol. 2007;48(2):145-9. doi:10.1080/02841850601128959
- 5. Suzuki S, Takizawa K, Nakajima Y, Katayama M, Sagawa F. CT Findings in Hepatic and Splenic Amyloidosis. J Comput Assist Tomogr. 1986;10(2):332-4. doi:10.1097/00004728-198603000-00034
- 6. Marmolya G, Karlins N, Petrelli M, McCullough A. Unusual Computed Tomography Findings in Hepatic Amyloidosis. Clin Imaging. 1990;14(3):248-50. doi:10.1016/0899-7071(90)90084-o
- 7. Ozcan H, Haliloglu M, Sokmensuer C, Akata D, Ozmen M, Karcaaltincaba M. Imaging for Abdominal Involvement in Amyloidosis. Diagn Interv Radiol. 2017;23(4):282-5. doi:10.5152/dir.2017.16484
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