Pseudocirrhosis
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At the time the article was created Maxime St-Amant had no recorded disclosures.
View Maxime St-Amant's current disclosuresAt the time the article was last revised Mohammad Taghi Niknejad had no financial relationships to ineligible companies to disclose.
View Mohammad Taghi Niknejad's current disclosures- Pseudo cirrhosis
Pseudocirrhosis is a radiological term used to convey the imaging findings of cirrhosis but emphasises that it occurs in the setting of hepatic metastases. It is most commonly reported following chemotherapeutic treatment of breast cancer metastases, although it has also been reported before treatment and with other malignancies, including pancreatic cancer, colon cancer, medullary thyroid cancer and oesophageal cancer 5.
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Terminology
The term "pseudocirrhosis" is intended to convey a different disease process compared with cirrhosis of chronic liver disease.
Clinical presentation
Although most cases are mainly identified on an imaging basis, particularly found on post-treatment surveillance scans, patients may have symptoms related to liver failure and portal hypertension, including abdominal distension due to ascites.
Pathology
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 an infiltrating tumour, occurring prior to chemotherapy
Radiographic features
Imaging manifestations on CT, ultrasound, and MRI may be identical to liver cirrhosis, and consist of:
variable capsular retraction and liver nodularity
hepatic segmental volume loss
nodular contour
confluent fibrosis
Quiz questions
References
- 1. Lee SL, Chang ED, Na SJ et-al. Pseudocirrhosis of breast cancer metastases to the liver treated by chemotherapy. Cancer Res Treat. 2014;46 (1): 98-103. doi:10.4143/crt.2014.46.1.98 - Free text at pubmed - Pubmed citation
- 2. Jeong WK, Choi SY, Kim J. Pseudocirrhosis as a complication after chemotherapy for hepatic metastasis from breast cancer. Clin Mol Hepatol. 2013;19 (2): 190-4. doi:10.3350/cmh.2013.19.2.190 - Free text at pubmed - Pubmed citation
- 3. Jha P, Poder L, Wang ZJ et-al. Radiologic mimics of cirrhosis. AJR Am J Roentgenol. 2010;194 (4): 993-9. doi:10.2214/AJR.09.3409 - Pubmed citation
- 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. doi:10.1007/s10620-006-9332-9 - Pubmed
- 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. doi:10.1159/000448066 - Pubmed
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