Pseudocirrhosis
Updates to Article Attributes
Pseudocirrhosis is a complicationterm used to recapitulate imaging findings of treatedcirrhosis, but occurring in the setting of hepatic metastases, mainly those of breast cancer, which mimics liver cirrhosis radiologically. It has been reported in up to 50% of patients with breast cancer and liver metastases who underwent chemotherapy treatment 1seen in the weeks or monthsmost commonly reported following commencementchemotherapeutic treatment of breast cancer metastases, although has also been reported prior to treatment, and with other malignancies 5.
ThereThe term "pseudocirrhosis" is some controversy regarding whether or not the termintended to convey a different disease process compared to cirrhosis of chronic liver disease, but there are similarities. Patients with findings of pseudocirrhosis is a misnomeroften present with liver failure, since patients may developascites, varices, and other findings of portal hypertension.
Two pathophysiologic correlates of pseudocirrhosis have been described 4:
- hepatic capsular retraction in response to chemotherapeutic agents, with nodular regenerative hyperplasia and absence of bridging fibrosis or cirrhosis on histopathology.
- extensive fibrosis representing a profound desmoplastic response to the infiltrating tumor, occurring prior to chemotherapy.
RadiographicImaging features
Radiological manifestations on CT scan, ultrasound, and MR may be identical to liver cirrhosis, and consist of:
-
variable capsular retraction and liver
MRI are the virtually same as for liver cirrhosis and consist mainly of:nodularity - hepatic segmental volume loss
- caudate lobe enlargement
capsular retraction
-<p><strong>Pseudocirrhosis</strong> is a complication of treated <a href="/articles/hepatic-metastases-1">hepatic metastases</a>, mainly those of <a href="/articles/breast-neoplasms">breast cancer</a>, which mimics <a href="/articles/cirrhosis">liver cirrhosis</a> radiologically. It has been reported in up to 50% of patients with breast cancer and liver metastases who underwent chemotherapy treatment <sup>1</sup>. It is seen in the weeks or months following commencement of treatment.</p><p>There is some controversy regarding whether or not the term pseudocirrhosis is a misnomer, since patients may develop <a href="/articles/portal-hypertension">portal hypertension</a>.</p><h4>Radiographic features</h4><p>Radiological manifestations on CT scan, ultrasound and liver MRI are the virtually same as for liver cirrhosis and consist mainly of:</p><ul>- +<p><strong>Pseudocirrhosis</strong> is a term used to recapitulate imaging findings of <a href="/articles/cirrhosis">cirrhosis</a>, but occurring in the setting of <a href="/articles/hepatic-metastases-1">hepatic metastases</a>. It is most commonly reported following chemotherapeutic treatment of breast cancer metastases, although has also been reported prior to treatment, and with other malignancies <sup>5</sup>.</p><p>The term "pseudocirrhosis" is intended to convey a different disease process compared to cirrhosis of chronic liver disease, but there are similarities. Patients with findings of pseudocirrhosis often present with <a href="/articles/acute-liver-failure">liver failure</a>, <a href="/articles/ascites">ascites</a>, <a href="/articles/portosystemic-collateral-pathways-1">varices</a>, and other findings of <a href="/articles/portal-hypertension">portal hypertension</a>. </p><p>Two pathophysiologic correlates of pseudocirrhosis have been described <sup>4</sup>:</p><ul>
- +<li>hepatic capsular retraction in response to chemotherapeutic agents, with nodular regenerative hyperplasia and absence of bridging fibrosis or cirrhosis on histopathology.</li>
- +<li>extensive fibrosis representing a profound desmoplastic response to the infiltrating tumor, occurring prior to chemotherapy.</li>
- +</ul><h4>Imaging features</h4><p>Radiological manifestations on CT, ultrasound, and MR may be identical to liver cirrhosis, and consist of:</p><ul>
- +<li>variable <a href="/articles/hepatic-capsular-retraction">capsular retraction</a> and liver nodularity</li>
-<li><a href="/articles/hepatic-capsular-retraction">capsular retraction</a></li>
References changed:
- 4. David A. Sass, Kenneth Clark, Dana Grzybicki, Mordechai Rabinovitz, Thomas A. Shaw-Stiffel. Diffuse Desmoplastic Metastatic Breast Cancer Simulating Cirrhosis with Severe Portal Hypertension: A Case of “Pseudocirrhosis”. (2007) Digestive Diseases and Sciences. 52 (3): 749. <a href="https://doi.org/10.1007/s10620-006-9332-9">doi:10.1007/s10620-006-9332-9</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17265127">Pubmed</a> <span class="ref_v4"></span>
- 5. Adike A, Karlin N, Menias C, Carey EJ. Pseudocirrhosis: A Case Series and Literature Review. (2016) Case reports in gastroenterology. 10 (2): 381-391. <a href="https://doi.org/10.1159/000448066">doi:10.1159/000448066</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27721722">Pubmed</a> <span class="ref_v4"></span>
Image 4 CT (C+ arterial phase) ( create )
