Top

Published in:

01-09-2016 | Hepatobiliary-Pancreas

Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver

Authors: Maxime Ronot, Anne Kerbaol, Pierre-Emmanuel Rautou, Giuseppe Brancatelli, Pierre Bedossa, Dominique Cazals-Hatem, Dominique-Charles Valla, Valérie Vilgrain

Published in: European Radiology | Issue 9/2016

Abstract

Purpose

To report the association of a mosaic enhancement pattern on contrast-enhanced CT or MR imaging and hepatic sinusoidal dilatation (SD) with acute inflammatory conditions affecting extrahepatic organs.

Methods

From 2007 to 2012, patients with acute inflammatory diseases who underwent contrast-enhanced CT and/or MRI of the liver with a mosaic enhancement pattern were selected. Clinico-biological and other imaging features were collected at diagnosis and during follow-up.

Results

Sixteen patients were included (15 women, median age 27 years; range 18–68). Five women (33 %) were receiving oral contraceptives. Acute inflammatory diseases included pyelonephritis (n = 10), pancreatitis (n = 2), pneumonia (n = 1), septicemia (n = 1), active Crohn's disease (n = 1), and infectious colitis (n = 1). Median white blood cell count was 13,250 cells/μL (range 11,500-18,000 cells/μL) and CRP level 94 mg/L (range 60–121 mg/L). Mosaic enhancement pattern was present in the whole liver and was prominent in the subcapsular areas. Four patients underwent liver biopsy confirming SD. Eleven patients underwent follow-up imaging showing normalized aspect in 9/11 patients after a median of 2 months.

Conclusion

Acute diseases of extrahepatic organs, associated with a marked systemic inflammatory syndrome should be added to the list of conditions causing a reversible hepatic sinusoidal dilatation as manifested by a mosaic enhancement pattern on contrast-enhanced CT or MR imaging.

Key Points

• Acute extrahepatic infectious/inflammatory diseases are a cause of transient MP.

• In most patients, MP was seen during both arterial and portal venous phase.

• In all patients, the mosaic enhancement pattern was diffuse, but more conspicuous in subcapsular areas.

• MP was no longer seen after resolution of the acute disease.

• No liver biopsy should be performed.

Kakar S, Kamath PS, Burgart LJ (2004) Sinusoidal dilatation and congestion in liver biopsy: is it always due to venous outflow impairment? Arch Pathol Lab Med 128:901–904PubMed

Rubbia-Brandt L, Audard V, Sartoretti P et al (2004) Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 15:460–466CrossRefPubMed

Marzano C, Cazals-Hatem D, Rautou PE, Valla D (2015) The significance of non-obstructive sinusoidal dilatation of the liver: Impaired portal perfusion or inflammatory reaction syndrome. Hepatology. doi:10.1002/hep.27747 PubMed

Cura M, Haskal Z, Lopera J (2009) Diagnostic and interventional radiology for Budd-Chiari syndrome. Radiographics 29:669–681CrossRefPubMed

Poulsen H, Winkler K, Christoffersen P (1970) The significance of centrilobular sinusoidal changes in liver biopsies. Scand J Gastroenterol Suppl 7:103–109PubMed

Levy VG, Bouma ME, Lageron A, Darnis F, Infante R (1978) Hepatic sinusoidal dilatation after chenodeoxycholic-acid therapy. Lancet 1:206CrossRefPubMed

Aoyagi T, Mori I, Ueyama Y, Tamaoki N (1989) Sinusoidal dilatation of the liver as a paraneoplastic manifestation of renal cell carcinoma. Hum Pathol 20:1193–1197CrossRefPubMed

Bruguera M, Caballero T, Carreras E, Aymerich M, Rodes J, Rozman C (1987) Hepatic sinusoidal dilatation in Hodgkin's disease. Liver 7:76–80CrossRefPubMed

Capron JP, Lemay JL, Gontier MF, Dupas JL, Capron-Chivrac D, Lorriaux A (1979) Hepatic sinusoidal dilatation in Crohn's disease. Scand J Gastroenterol 14:987–992PubMed

10.

Curciarello J, Castelletto R, Barbero R et al (1998) Hepatic sinusoidal dilatation associated to giant lymph node hyperplasia (Castleman's): a new case in a patient with periorbital xanthelasmas and history of celiac disease. J Clin Gastroenterol 27:76–78CrossRefPubMed

11.

Durant C, Martin J, Hervier B, Gournay J, Hamidou M (2011) Takayasu arteritis associated with hepatic sinusoidal dilatation. Ann Hepatol 10:559–561PubMed

12.

Gerlag PG, Lobatto S, Driessen WM et al (1985) Hepatic sinusoidal dilatation with portal hypertension during azathioprine treatment after kidney transplantation. J Hepatol 1:339–348CrossRefPubMed

13.

Gerlag PG, van Hooff JP (1987) Hepatic sinusoidal dilatation with portal hypertension during azathioprine treatment: a cause of chronic liver disease after kidney transplantation. Transplant Proc 19:3699–3703PubMed

14.

Jacobi AM, Feist E, Rudolph B, Burmester GR (2004) Sinusoidal dilatation: a rare side effect of azathioprine. Ann Rheum Dis 63:1702–1703CrossRefPubMedPubMedCentral

15.

Laffon A, Moreno A, Gutierrez-Bucero A, Ossorio C, Sabando P, Moreno-Otero R (1989) Hepatic sinusoidal dilatation in rheumatoid arthritis. J Clin Gastroenterol 11:653–657CrossRefPubMed

16.

Saadoun D, Cazals-Hatem D, Denninger M-H et al (2004) Association of idiopathic hepatic sinusoidal dilatation with the immunological features of the antiphospholipid syndrome. Gut 53:1516–1519CrossRefPubMedPubMedCentral

17.

Scoazec JY, Marche C, Girard PM et al (1988) Peliosis hepatis and sinusoidal dilation during infection by the human immunodeficiency virus (HIV). An ultrastructural study. Am J Pathol 131:38–47PubMedPubMedCentral

18.

Valla D, Benhamou JP (1988) Drug-induced vascular and sinusoidal lesions of the liver. Baillieres Clin Gastroenterol 2:481–500CrossRefPubMed

19.

Camilleri M, Schafler K, Chadwick VS, Hodgson HJ, Weinbren K (1981) Periportal sinusoidal dilatation, inflammatory bowel disease, and the contraceptive pill. Gastroenterology 80:810–815PubMed

20.

Agostini J, Benoist S, Seman M et al (2012) Identification of molecular pathways involved in oxaliplatin-associated sinusoidal dilatation. J Hepatol 56:869–876CrossRefPubMed

21.

Balazs M (1988) Sinusoidal dilatation of the liver in patients on oral contraceptives. Electron microscopical study of 14 cases. Exp Pathol 35:231–237CrossRefPubMed

22.

Fischer D, Kemeny F, Rauturseau J, Marty M, Karsenti P (1982) Massive, painful hepatomegaly, sinusoidal dilatation and prolonged use of estroprogestational agents. Gastroenterol Clin Biol 6:302–304PubMed

23.

Perarnau J-M, Bacq Y (2008) Hepatic vascular involvement related to pregnancy, oral contraceptives, and estrogen replacement therapy. Semin Liver Dis 28:315–327CrossRefPubMed

24.

Spellberg MA, Mirro J, Chowdhury L (1979) Hepatic sinusoidal dilatation related to oral contraceptives. A study of two patients showing ultrastructural changes. Am J Gastroenterol 72:248–252PubMed

25.

Valla D, Benhamou JP (1988) Liver diseases related to oral contraceptives. Dig Dis 6:76–86CrossRefPubMed

26.

Winkler K, Poulsen H (1975) Liver disease with periportal sinusoidal dilatation. A possible complication to contraceptive steroids. Scand J Gastroenterol 10:699–704PubMed

27.

Yang DM, Jung DH, Park CH, Kim JE, Choi SJ (2004) Imaging findings of hepatic sinusoidal dilatation. Am J Roentgenol 183:1075–1077CrossRef

28.

Yao JC, Shah MH, Ito T et al (2011) Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med 364:514–523CrossRefPubMedPubMedCentral

29.

Bruguera M, Aranguibel F, Ros E, Rodes J (1978) Incidence and clinical significance of sinusoidal dilatation in liver biopsies. Gastroenterology 75:474–478PubMed

30.

de Kerguenec C, Hillaire S, Molinie V et al (2001) Hepatic manifestations of hemophagocytic syndrome: a study of 30 cases. Am J Gastroenterol 96:852–857CrossRefPubMed

31.

Clotet B, Navas J, Grifol M, Rubies-Prat J, Foz M (1986) Liver sinusoidal dilatation in familial Mediterranean fever. Arch Intern Med 146:1243CrossRefPubMed

32.

Fiorillo A, Migliorati R, Vajro P, Pellegrini F, Caldore M (1983) Hepatic sinusoidal dilation in the course of histiocytosis X. J Pediatr Gastroenterol Nutr 2:332–334CrossRefPubMed

33.

Iannaccone R, Federle MP, Brancatelli G et al (2006) Peliosis hepatis: spectrum of imaging findings. AJR Am J Roentgenol 187:W43–W52CrossRefPubMed

34.

Fisher MR, Neiman HL (1984) Periportal sinusoidal dilatation associated with pregnancy. Cardiovasc Intervent Radiol 7:299–302CrossRefPubMed

35.

Maione D, Di Carlo E, Li W et al (1998) Coexpression of IL-6 and soluble IL-6R causes nodular regenerative hyperplasia and adenomas of the liver. EMBO J 17:5588–5597CrossRefPubMedPubMedCentral

36.

Schirmacher P, Peters M, Ciliberto G et al (1998) Hepatocellular hyperplasia, plasmacytoma formation, and extramedullary hematopoiesis in interleukin (IL)-6/soluble IL-6 receptor double-transgenic mice. Am J Pathol 153:639–648CrossRefPubMedPubMedCentral

37.

Paradis V, Benzekri A, Dargere D et al (2004) Telangiectatic focal nodular hyperplasia: a variant of hepatocellular adenoma. Gastroenterology 126:1323–1329CrossRefPubMed

38.

Paradis V, Champault A, Ronot M et al (2007) Telangiectatic adenoma: an entity associated with increased body mass index and inflammation. Hepatology 46:140–146CrossRefPubMed

39.

Zafrani ES, von Pinaudeau Y, Dhumeaux D (1983) Drug-induced vascular lesions of the liver. Arch Intern Med 143:495–502CrossRefPubMed

40.

Foxman B (2003) Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon DM 49:53–70CrossRefPubMed

Title: Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver
Authors: Maxime Ronot
Anne Kerbaol
Pierre-Emmanuel Rautou
Giuseppe Brancatelli
Pierre Bedossa
Dominique Cazals-Hatem
Dominique-Charles Valla
Valérie Vilgrain
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 9/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4124-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acute extrahepatic infectious or inflammatory diseases are a cause of transient mosaic pattern on CT and MR imaging related to sinusoidal dilatation of the liver

Abstract

Purpose

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Key Points

Please log in to get access to this content

Other articles of this Issue 9/2016

Which is the best current guideline for the diagnosis and management of cystic pancreatic neoplasms? An appraisal using evidence-based practice methods

A comparison of digital tomosynthesis and chest radiography in evaluating airway lesions using computed tomography as a reference

The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using 99mTc-ECD SPECT

Disrupted white matter structure underlies cognitive deficit in hypertensive patients

Computed tomography findings for a gastric lymphoepithelioma-like carcinoma: How often does it present as a submucosal mass?

Quantitative evaluation of beam-hardening artefact correction in dual-energy CT myocardial perfusion imaging