Hepatic amyloidosis
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.
Related Radiopaedia articles
Hepatobiliary pathology
- depositional disorders
- infection and inflammation
- liver abscess
- hepatic hydatid infection
- cirrhosis
- hepatitis
- cholecystitis
- cholangitis
- malignancy
- liver and intrahepatic bile duct tumors
- benign epithelial tumors
- hepatocellular hyperplasia
- hepatocellular adenoma
- hepatic/biliary cysts
- benign nonepithelial tumors
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- hepatocellular carcinoma
- hepatocellular carcinoma variants
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cholangiocarcinoma
- intra-hepatic
- mass-forming type
- periductal infiltrating type - Klatskin tumors
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- hepatoblastoma
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- miscellaneous
- adrenal rest tumors
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- hepatic fibroma
- hepatic Kaposi sarcoma
- hepatic lipoma
- hepatic mesenchymal hamartoma
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- hepatic rhabdoid tumor
- hepatic solitary fibrous tumor
- hepatic teratoma
- hepatic yolk sac tumor
- inflammatory myofibroblastic tumor (inflammatory pseudotumor)
- nodular regenerative hyperplasia
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- metabolic
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vascular and perfusion disorders
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- third inflow
- liver thrombotic angiitis
- infra diaphragmatic total anomalous pulmonary venous return (TAPVR)
- hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease)