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Insights into Imaging
Published in: Insights into Imaging 1/2020

01-12-2020 | Computed Tomography | Educational Review

Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?

Authors: Ali Devrim Karaosmanoglu, Aycan Uysal, Musturay Karcaaltincaba, Deniz Akata, Mustafa Nasuh Ozmen, Jessica Kraeft, Peter F. Hahn

Published in: Insights into Imaging | Issue 1/2020

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Abstract

Despite the success of cross-sectional imaging in evaluating hepatopancreatobiliary system malignancies, several non-malignant disease processes may closely mimic malignancy. Differentiating these benign diseases from malignancy may be difficult, or even impossible, even in the hands of experienced imagers. In this manuscript, we present benign mimics involving the hepatopancreatobiliary system and try to increase awareness of these potential pitfalls.
Literature
1.
Alobaidi M, Shirkhoda A (2004) Benign focal liver lesions: discrimination from malignant mimickers. Curr Probl Diagn Radiol 33(6):239–253PubMedCrossRef
2.
Gandhi NS, Feldman MK, Le O, Morris-Stiff G (2018) Imaging mimics of pancreatic ductal adenocarcinoma. Abdom Radiol (NY) 43(2):273–284CrossRef
3.
Mortele KJ, Segatto E, Ros PR (2004) The infected liver: radiologic-pathologic correlation. Radiographics 24(4):937–955PubMedCrossRef
4.
Pastakia B, Shawker TH, Thaler M, O'Leary T, Pizzo PA (1988) Hepatosplenic candidiasis: wheels within wheels. Radiology 166(2):417–421PubMedCrossRef
5.
Cornely OA, Bangard C, Jaspers NI (2015) Hepatosplenic candidiasis. Clin Liver Dis (Hoboken) 6(2):47–50CrossRef
6.
Metser U, Haider MA, Dill-Macky M, Atri M, Lockwood G, Minden M (2005) Fungal liver infection in immunocompromised patients: depiction with multiphasic contrast-enhanced helical CT. Radiology 235(1):97–105PubMedCrossRef
7.
Berlow ME, Spirt BA, Weil L (1984) CT follow-up of hepatic and splenic fungal microabscesses. J Comput Assist Tomogr 8(1):42–45PubMedCrossRef
8.
Anttila VJ, Lamminen AE, Bondestam S et al (1996) Magnetic resonance imaging is superior to computed tomography and ultrasonography in imaging infectious liver foci in acute leukaemia. Eur J Haematol 56(1-2):82–87CrossRef
9.
Semelka RC, Kelekis NL, Sallah S, Worawattanakul S, Ascher SM (1997) Hepatosplenic fungal disease: diagnostic accuracy and spectrum of appearances on MR imaging. AJR Am J Roentgenol 169(5):1311–1316PubMedCrossRef
10.
Semelka RC, Patrick Shoenut J, Greenberg HM, Bow EJ (1992) Detection of acute and treated lesions of hepatosplenic candidiasis: comparison of dynamic contrast-enhanced CT and MR imaging. J Magn Reson Imaging 2(3):341–345PubMedCrossRef
11.
Shirkhoda A, Lopez-Berestein G, Holbert JM, Luna MA (1986) Hepatosplenic fungal infection: CT and pathologic evaluation after treatment with liposomal amphotericin B. Radiology 159(2):349–353PubMedCrossRef
12.
Balci NC, Tunacı A, Akınci A, Cevikbaş U (2001) Granulomatous hepatitis: MRI findings. Magn Reson Imaging 19(8):1107–1111PubMedCrossRef
13.
Karaosmanoglu AD, Onur MR, Sahani DV, Tabari A, Karcaaltincaba M (2016) Hepatobiliary tuberculosis: imaging findings. AJR Am J Roentgenol 207(4):694–704PubMedCrossRef
14.
Kakkar C, Polnaya AM, Koteshwara P, Smiti S, Rajagopal KV, Arora A (2015) Hepatic tuberculosis: a multimodality imaging review. Insights Imaging 6(6):647–658PubMedPubMedCentralCrossRef
15.
16.
Jain R, Sawhney S, Gupta RG, Acharya SK (1999) Sonographic appearances and percutaneous management of primary tuberculous liver abscess. J Clin Ultrasound 27(3):159–163PubMedCrossRef
17.
Mills P, Saverymuttu S, Fallowfield M, Nussey S, Joseph AE (1990) Ultrasound in the diagnosis of granulomatous liver disease. Clin Radiol 41(2):113–115PubMedCrossRef
18.
Hickey N, McNulty JG, Osborne H, Finucane J (1999) Acute hepatobiliary tuberculosis: a report of two cases and a review of the literature. Eur Radiol 9(5):886–889PubMedCrossRef
19.
Kantarci M, Bayraktutan U, Karabulut N et al (2012) Alveolar echinococcosis: spectrum of findings at cross-sectional imaging. Radiographics 32(7):2053–2070PubMedCrossRef
20.
Akhan O, Ozmen MN, Dincer A, Sayek I, Göçmen A (1996) Liver hydatid disease: long-term results of percutaneous treatment. Radiology 198(1):259–264PubMedCrossRef
21.
Mortele KJ, Ros PR (2001) Cystic focal liver lesions in the adult: differential CT and MR imaging features. Radiographics 21(4):895–910PubMedCrossRef
22.
Land MA, Moinuddin M, Bisno AL (1985) Pyogenic liver abscess: changing epidemiology and prognosis. South Med J 78(12):1426–1430PubMedCrossRef
23.
24.
Bächler P, Baladron MJ, Menias C et al (2016) Multimodality Imaging of liver infections: differential diagnosis and potential pitfalls. Radiographics 36(4):1001–1023PubMedCrossRef
25.
Ralls PW, Colletti PM, Quinn MF, Halls J (1982) Sonographic findings in hepatic amebic abscess. Radiology 145(1):123–126PubMedCrossRef
26.
Radin DR, Ralls PW, Colletti PM, Halls JM (1988) CT of amebic liver abscess. AJR Am J Roentgenol 150(6):1297–1301PubMedCrossRef
27.
Kwon JW, Kim TW, Kim KM et al (2011) Clinical features of clinically diagnosed eosinophilic liver abscesses. Hepatol Int 5(4):949–954PubMedCrossRef
28.
29.
Yoo SY, Han JK, Kim YH, Kim TK, Choi BI, Han MC (2003) Focal eosinophilic infiltration in the liver: radiologic findings and clinical course. Abdom Imaging 28(3):326–332PubMedCrossRef
30.
Lim JH, Mairiang E, Ahn GH (2008) Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis. Abdom Imaging 33(2):157–165PubMedCrossRef
31.
Kaya M, Beştaş R, Cetin S (2011) Clinical presentation and management of Fasciola hepatica infection: single-center experience. World J Gastroenterol 17(44):4899–4904PubMedPubMedCentralCrossRef
32.
33.
Maincent G, Labadie H, Fabre M et al (1997) Tertiary hepatic syphilis. A treatable cause of multinodular liver. Dig Dis Sci 42(2):447–450
34.
Veeravahu M (1985) Diagnosis of liver involvement in early syphilis. A critical review. Arch Intern Med 145(1):132–134PubMedCrossRef
35.
36.
Peeters L, Van WV, der Perre Van C, Lagrange W, Verbeke M (2005) Tertiary syphilis presenting as hepatic bull's eye lesions. Acta Gastroenterol Belg 68(4):435–439
37.
Shapiro MP, Gale ME (1987) Tertiary syphilis of the liver: CT appearance. J Comput Assist Tomogr 11(3):546–547PubMedCrossRef
38.
Zaidi SA, Singer C (2002) Gastrointestinal and hepatic manifestations of tickborne diseases in the United States. Clin Infect Dis 34(9):1206–1212PubMedCrossRef
39.
Ortego TJ, Hutchins LF, Rice J, Davis GR (1986) Tularemic hepatitis presenting as obstructive jaundice. Gastroenterology 91(2):461–463PubMedCrossRef
40.
Baptista MA, Lo DS, Hein N et al (2014) Cat-scratch disease presenting as multiple hepatic lesions: case report and literature review. Autops Case Rep 4(2):43–48PubMedCrossRefPubMedCentral
41.
Stuart SM, Nowicki MJ (1998) Radiological case of the month. Cat-scratch disease with hepatic and splenic involvement. Arch Pediatr Adolesc Med 152(8):823–824PubMedCrossRef
42.
43.
Islam T, Athar MN, Athar MK, Usman MH, Misbah B (2005) Hepatic actinomycosis with infiltration of the diaphragm and right lung: a case report. Can Respir J 12(6):336–337PubMedCrossRef
44.
Kim HS, Park NH, Park KA, Kang SB (2007) A case of pelvic actinomycosis with hepatic actinomycotic pseudotumor. Gynecol Obstet Invest 64(2):95–99PubMedCrossRef
45.
Koyama T, Ueda H, Togashi K, Umeoka S, Kataoka M, Nagai S (2004) Radiologic manifestations of sarcoidosis in various organs. Radiographics 24(1):87–104PubMedCrossRef
46.
Warshauer DM, Lee JK (2004) Imaging manifestations of abdominal sarcoidosis. AJR Am J Roentgenol 182(1):15–28PubMedCrossRef
47.
Dourakis SP, Cokkinos DD, Soultati AS, Alexopoulou A, Nezi V, Archimandritis AJ (2007) A case of liver sarcoidosis mimicking cirrhosis. Clin Imaging 31(1):47–49PubMedCrossRef
48.
Deshpande V, Zen Y, Chan JK et al (2012) Consensus statement on the pathology of IgG4-related disease. Mod Pathol 25(9):1181–1192
49.
Chen JH, Deshpande V (2017) IgG4-related disease and the liver. Gastroenterol Clin North Am 46(2):195–216PubMedCrossRef
50.
Zen Y, Fujii T, Sato Y, Masuda S, Nakanuma Y (2007) Pathological classification of hepatic inflammatory pseudotumor with respect to IgG4-related disease. Mod Pathol 20(8):884–894PubMedCrossRef
51.
Akatsu T, Wakabayashi G, Tanimoto A, Kameyama K, Kitajima M (2006) Inflammatory pseudotumor of the liver masquerading as hepatocellular carcinoma after a hepatitis B virus infection: report of a case. Surg Today 36(11):1028–1031PubMedCrossRef
52.
53.
Honmyo N, Kobayashi T, Tashiro H et al (2016) Inflammatory pseudotumor of the liver occurring during the course of hepatitis C virus-related hepatocellular carcinoma treatment: A case report. Int J Surg Case Rep 20:96–100PubMedPubMedCentralCrossRef
54.
Sakai M, Ikeda H, Suzuki N et al (2001) Inflammatory pseudotumor of the liver: case report and review of the literature. J Pediatr Surg 36(4):663–666PubMedCrossRef
55.
Chen CB, Chou CT, Hsueh C, Lee KW, Chen YL (2013) Hepatic inflammatory pseudotumor mimicking hepatocellular carcinoma. J Chin Med Assoc 76(5):299–301PubMedCrossRef
56.
Caramella T, Novellas S, Fournol M, Saint-Paul MC, Bruneton JN, Chevallier P (2007) Imaging of inflammatory pseudotumors of the liver. J Radiol 88(6):882–888
57.
Roux M, Baranes L, Decaens T et al (2013) Recurring multicystic inflammatory pseudotumor of the liver: a case report. Clin Res Hepatol Gastroenterol 37(2):e51–e57PubMedCrossRef
58.
Ramamurthy NK, Rudralingam V, Martin DF, Galloway SW, Sukumar SA (2013) Out of sight but kept in mind: complications and imitations of dropped gallstones. AJR Am J Roentgenol 200(6):1244–1253PubMedCrossRef
59.
Sathesh-Kumar T, Saklani AP, Vinayagam R, Blackett RL (2004) Spilled gall stones during laparoscopic cholecystectomy: a review of the literature. Postgrad Med J 80(940):77–79PubMedPubMedCentralCrossRef
60.
Rice DC, Memon MA, Jamison RL et al (1997) Long-term consequences of intraoperative spillage of bile and gallstones during laparoscopic cholecystectomy. J Gastrointest Surg 1(1):85–90 discussion 90-1PubMedCrossRef
61.
Levy AD, Murakata LA, Rohrmann CA Jr (2001) Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics 21(2):295–314 questionnaire, 549-55PubMedCrossRef
62.
Ros PR, Goodman ZD (1997) Xanthogranulomatous cholecystitis versus gallbladder carcinoma. Radiology 203(1):10–12PubMedCrossRef
63.
Zhao F, Lu PX, Yan SX et al (2013) CT and MR features of xanthogranulomatous cholecystitis: an analysis of consecutive 49 cases. Eur J Radiol 82(9):1391–1397PubMedCrossRef
64.
Saluja SS, Ray S, Pal S et al (2007) Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg 7:10
65.
Fan ST, Ng IO, Choi TK, Lai E (1989) Tuberculosis of the bile duct: a rare cause of biliary stricture. Am J Gastroenterol 84(4):413–414
66.
Vlachou PA, Khalili K, Jang HJ, Fischer S, Hirschfield GM, Kim TK (2011) IgG4-related sclerosing disease: autoimmune pancreatitis and extrapancreatic manifestations. Radiographics 31(5):1379–1402PubMedCrossRef
67.
Hedgire SS, McDermott S, Borczuk D, Elmi A, Saini S, Harisinghani MG (2013) The spectrum of IgG4-related disease in the abdomen and pelvis. AJR Am J Roentgenol 201(1):14–22PubMedCrossRef
68.
Martínez-de-Alegría A, Baleato-González S, García-Figueiras R et al (2015) IgG4-related disease from head to toe. Radiographics 35(7):2007–2025PubMedCrossRef
69.
Ryan DP, Hong TS, Bardeesy N (2014) Pancreatic adenocarcinoma. N Engl J Med 371(22):2140–2141PubMed
70.
Hart PA, Zen Y, Chari ST (2015) Recent advances in autoimmune pancreatitis. Gastroenterology 149(1):39–51PubMedCrossRef
71.
Zhang L, Chari S, Smyrk TC et al (2011) Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas 40(8):1172–1179PubMedCrossRef
72.
Lee LK, Sahani DV (2014) Autoimmune pancreatitis in the context of IgG4-related disease: review of imaging findings. World J Gastroenterol 20(41):15177–15189PubMedPubMedCentralCrossRef
73.
Wakabayashi T, Kawaura Y, Satomura Y et al (2003) Clinical and imaging features of autoimmune pancreatitis with focal pancreatic swelling or mass formation: comparison with so-called tumor-forming pancreatitis and pancreatic carcinoma. Am J Gastroenterol 98(12):2679–2687PubMedCrossRef
74.
Fattahi R, Balci NC, Perman WH et al (2009) Pancreatic diffusion-weighted imaging (DWI): comparison between mass-forming focal pancreatitis (FP), pancreatic cancer (PC), and normal pancreas. J Magn Reson Imaging 29(2):350–356PubMedCrossRef
75.
Patlas M, Deitel W, Taylor B, Gallinger S, Wilson SR (2007) Focal chronic pancreatitis mimicking pancreatic head carcinoma: are there suggestive features on ultrasound? Can Assoc Radiol J 58(1):15–21
76.
Johnson PT, Outwater EK (1999) Pancreatic carcinoma versus chronic pancreatitis: dynamic MR imaging. Radiology 212(1):213–218PubMedCrossRef
77.
78.
Zacharia GS, Antony R, Kolassery S, Ramachandran TM (2014) Isolated pancreatic tuberculosis masquerading as pancreatic cancer. Gastroenterol Rep (Oxf) 2(2):154–157PubMedPubMedCentralCrossRef
79.
Falkowski AL, Graber J, Haack HG, Tarr PE, Rasch H (2013) Isolated pancreatic tuberculosis: a case report and radiological comparison with cystic pancreatic lesions. J Radiol Case Rep 7(1):1–11
80.
Hart RG, Kagan-Hallet K, Joerns SE (1987) Mechanisms of intracranial hemorrhage in infective endocarditis. Stroke 18(6):1048–1056PubMedCrossRef
81.
82.
Sheil AG, Reeve TS, Little JM, Coupland GA, Loewenthal J (1969) Aorto-intestinal fstulas following operations on the abdominal aorta and iliac arteries. Br J Surg 56(11):840–843PubMedCrossRef
Metadata
Title
Non-neoplastic hepatopancreatobiliary lesions simulating malignancy: can we differentiate?
Authors
Ali Devrim Karaosmanoglu
Aycan Uysal
Musturay Karcaaltincaba
Deniz Akata
Mustafa Nasuh Ozmen
Jessica Kraeft
Peter F. Hahn
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
Insights into Imaging / Issue 1/2020
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-019-0813-8

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