Macroregenerative siderotic hepatic nodule

Case contributed by Avni K P Skandhan

Presentation

Known case of cirrhosis on regular follow up scan was found to have a iso to hyperdense mass lesion in the right lobe of liver.

Patient Data

Age: 40 years
Gender: Male

Large well defined, solid lesion seen in segment IV of liver. It is mildly hyperdense on non-contrast and arterial phase and appears isodense on portal and delayed phase. Minimal enhancement noted. No central scar/calcification/fat/arterial enhancement noted. With these features the possibility of siderotic regenerative nodule was suggested which was further confirmed on MRI (images not available).

Case Discussion

Patients with cirrhosis can accumulate focal iron within regenerative or dysplastic hepatic nodules, hence they are 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.

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.

MRI is more sensitive in characterizing them.

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