Answer for CoW 06 Aug 2017
CA BREAST WITH LIVER METASTASES AND PSEUDOCIRRHOSIS APPEARANCE
Findings
Large mixed intense lesion with restricted diffusion noted in left lobe involving the porta hepatis and with infiltration of the common hepatic duct – metastasis. o Dilated intra hepatic biliary radicles and the hepatic ducts. Multiple small discrete lesions in rest of the liver parenchyma with irregular nodular liver surface – metastases with pseudocirrhosis appearance Numerous peritoneal nodular lesions in right subphrenic and right subhepatic regions. Minimal ascites. Significant right pleural effusion.
Discussion
The above patient is already diagnosed as Carcinoma Breast and now presented with abdominal pain and jaundice. Pseudocirrhosis related to treated metastatic breast cancer mimics infiltrative Hepatocellular carcinoma because changes after therapy can include a combination of atrophy, fibrosis, and regeneration, resulting in a dysmorphic configuration and manifestations of portal hypertension—findings similar to those seen in cirrhosis.
RADIOGRAPHICS:March-April 2015 Volume 35, Issue 2 Infiltrative Hepatocellular Carcinoma: What Radiologists Need to Know Arich R. Reynolds, Alessandro Furl etal
Findings
Large mixed intense lesion with restricted diffusion noted in left lobe involving the porta hepatis and with infiltration of the common hepatic duct – metastasis. o Dilated intra hepatic biliary radicles and the hepatic ducts. Multiple small discrete lesions in rest of the liver parenchyma with irregular nodular liver surface – metastases with pseudocirrhosis appearance Numerous peritoneal nodular lesions in right subphrenic and right subhepatic regions. Minimal ascites. Significant right pleural effusion.
Discussion
The above patient is already diagnosed as Carcinoma Breast and now presented with abdominal pain and jaundice. Pseudocirrhosis related to treated metastatic breast cancer mimics infiltrative Hepatocellular carcinoma because changes after therapy can include a combination of atrophy, fibrosis, and regeneration, resulting in a dysmorphic configuration and manifestations of portal hypertension—findings similar to those seen in cirrhosis.
RADIOGRAPHICS:March-April 2015 Volume 35, Issue 2 Infiltrative Hepatocellular Carcinoma: What Radiologists Need to Know Arich R. Reynolds, Alessandro Furl etal
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!