Presentation
Referred from the clinic with possible hepatosplenomegaly.
Patient Data
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Liver is enlarged in size, measures 19.2 cm in span and shows mild diffuse fatty infiltrative changes.
Few areas of focal fatty sparing are present in the hepatic parenchyma, adjacent to the GB fossa and left hepatic lobe.
In addition, there is presence of an irregular hypoechoic solid lesion of 4.6 x 4.4 cm size, without significant increased vascularity within, in segment 5.
No intrahepatic biliary ductal dilatation.
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A large hypodense lesion is present in segment V of right hepatic lobe, showing mild peripheral enhancement on arterial phase scan, centripetal enhancement on portovenous phase scan and almost complete homogenous enhancement on delayed phase scan, suggesting hemangioma.
No intrahepatic biliary ductal dilatation.
Moderate splenomegaly with no focal lesion. No significant lymphadenopathy.
Case Discussion
Hepatic hemangiomas are benign non-neoplastic hypervascular liver lesions which are usually an incidental finding on imaging. Most patients are asymptomatic.
On ultrasound they are typically well-defined hyperechoic lesions. In 10% of cases they are hypoechoic, especially in fatty liver where the parenchyma itself is of increased echogenicity as in our case. The CT features in this case are typical of hemangiomas.
Special thanks to Dr.Airon, Nitin to help in submitting this case.
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