Hepatic haemosiderosis

Hepatic haemosiderosis refers to the deposition of haemosiderin in the liver.

Hepatic iron overload can be in the form of 7:

  • diffuse
  • heterogeneous
  • segmental
  • focal
  • hypersiderosis
  • intralesional siderosis
  • periportal siderosis.

In the absence of genetic haemochromatosis and systemic haemosiderosis, patients with cirrhosis can accumulate focal iron within regenerative or dysplastic hepatic nodules, commonly referred to as 'siderotic nodules'. Siderotic dysplastic nodules are considered premalignant lesions while siderotic regenerative nodules are a marker for severe viral or alcoholic cirrhosis.

Siderotic nodules stain strongly with Prussian blue on histological specimens 6

If there are iron deposits above a certain level, siderotic regenerating nodules may appear as high attenuating nodules on CT or as heterogeneous regions of high-density liver parenchyma 3.

MRI is more sensitive than CT in demonstrating siderotic regenerating nodules. The detection of siderotic nodules can be improved with the use of GRE pulse sequences with longer TEs 2

Regenerative siderotic nodules cannot be reliably distinguished from dysplastic siderotic nodules with MR imaging 5.

Reported signal characteristics of hepatic siderotic nodules 2:

  • T1: low signal
  • STIR: low signal
  • gradient echo (GE): low signal
Hepatobiliary pathology
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Article information

rID: 16858
Tag: cases
Synonyms or Alternate Spellings:
  • Siderosis of the liver
  • Hepatic siderosis
  • Liver siderosis
  • Haemosiderosis of the liver
  • Hemosiderosis of the liver
  • Liver hemosiderosis
  • Hepatic iron overload

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Cases and figures

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    Case 1: diffuse in thalassaemia
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    Case 2: in sickle cell anaemia
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