focal fatty sparing adjacent to the gallbladder

Motohisa Kato, Shigetoyo Saji, Masayuki Kanematsu, Daizo Fukada, Kiichi Miya, Takao Umemoto, Katsuyuki Kunieda, Yasuyuki Sugiyama, Ikuhide Kuwahara, Kuniyasu Shimokawa, A Case of Liver Metastasis from Colon Cancer Masquerading as Focal Sparing in a Fatty Liver, Japanese Journal of Clinical Oncology, Volume 27, Issue 3, June 1997, Pages 189192, https://doi.org/10.1093/jjco/27.3.189. and Strunk et al. Out of the 269 patients deemed eligible for analysis, 76 (28.3%) had fatty liver at baseline imaging, prior to treatment with adjuvant chemotherapy. However, it occasionally creates some problems in the diagnosis of hepatic mass lesions. Sohn J, Siegelman E, Osiason A. Srensen, P.; Edal, A.; Madsen, E.; Fenger, C.; Poulsen, M.R. (2010) Prevalence and risk factors of focal sparing in hepatic steatosis. Hepatic steatosis secondary to capecitabine: A case report. (2001) Frequency of benign hepatic lesions incidentally detected with contrast-enhanced thin-section portal venous phase spiral CT. Acta Radiol 42:172520, Lam KY (2002) Autopsy findings in diabetic patients: a 27year clinicopathologic study with emphasi on opportunistic infections and cancers. PubMed The relative risk of developing steatosis was not significantly different regardless of statin therapy status at the time of adjuvant chemotherapy (RR 0.45, 95% CI 0.10 to 2.75) after adjusting for sex, BMI, type 2 diabetes mellitus, and hyperlipidemia (, In the present study, the adjusted relative risk of adjuvant chemotherapy reflected a moderately increased risk of steatosis, although the confidence intervals were wide. Is hepatic steatosis reversible? The number of recent ultrasound studies on the prevalence of benign liver lesions is relatively limited. is fatty lever curable? Studies concerning the prevalence of benign focal liver lesions present a quite heterogeneous picture as regards the precise research question posed, the size of the population studied, and the investigative methods used. Chemotherapy-associated steatosis is poorly understood in the context of colorectal cancer. Nodular focal fatty sparing of liver sometimes is a mimicker of malignant lesion, especially metastatic tumor. It was most often found in the 5160years age group; the mean age of the patients with focal fatty sparing was 54.914.5years. Chemotherapy-associated steatosis is poorly understood in the context of colorectal cancer. 2 test for categorical variables, unless the sample size was too small, in which case Fishers exact test was used. The data presented in this study are available on request from the corresponding author. Vigano, L.; De Rosa, G.; Toso, C.; Andres, A.; Ferrero, A.; Roth, A.; Sperti, E.; Majno, P.; Rubbia-Brandt, L. Reversibility of chemotherapy-related liver injury. Solitary cysts were found in 62.8% (n=1652) of cases. methods, instructions or products referred to in the content. Parts of this manuscript were presented at the Ultrasound Dreilndertreffen 2008, Davos. 3). By definition, fatty sparing occurs in patients with diffuse fatty infiltration of the liver, which may be idiopathic or secondary to obesity, starvation, parenteral nutrition, steroid therapy, diabetes mellitus, alcohol, and hepatitis. Ultraschall Med 30:383389, Bioulac-Sage P, Laumonier H, Couchy G, et al. Since drug-induced hepatotoxicity was described by Grieco et al. In order to be human-readable, please install an RSS reader. ; Siu, L.L. 76.67% (n=1157) of diagnosed hemangiomas were solitary, and the average size of the hemangiomas was 20.1mm. Rofo 156:325327, Koseoglu K, Ozsunar Y, Taskin F, Karaman C (2005) Pseudolesions of left liver lobe during helical CT examinations: prevalence and comparison between unenhanced and biphasic CT findings. Unusual patterns of hepatic steatosis caused by the local effect of insulin revealed on chemical shift MR imaging. Most studies have also found a gender-dependent aspect, with higher prevalence figures for hepatic cysts in women [22, 23, 29, 30]. Of 269 patients, 76 (28.3%) had steatosis at baseline. 1991;181 (3): 809-12. Considerably more studies have investigated the prevalence of hepatic hemangioma than of focal fatty sparing, FNH, and adenoma [6, 7, 9, 11, 21]. ; Lee, H.S. Only a very few studies investigated the prevalence of FNH, hepatic adenoma, and focal fatty sparing. Preoperative CT scan and magnetic resonance (MR) imaging in 1993 had shown a slightly fatty liver and no metastasis. The prevalence of FNH lies between 0.8% and 3.2% [1215], of hepatic adenoma from 0.4% to 1.5% [11, 12, 15, 16], and of focal fatty sparing between 7.2% and 19.8% [8, 17, 18]. Unfortunately, we cannot compare our results on age and gender distribution or those concerning the average size of the hepatic adenoma with any of the studies available to us. When located in characteristic locations then there is usually little difficulty in making the correct diagnosis. ; Saeian, K.; Lalehzari, M.; Aronsohn, A.; Gorospe, E.C. MRI exhibits the highest sensitivity for detecting hepatic lipid infiltration and can detect as little as 5% steatosis in the liver at a sensitivity of 76.790.0% and a specificity of 87.191% [, Another limitation of this study is the relatively small sample size, particularly for the cohort of patients receiving statins. ; Sada, Y.H. Tanja Eva-Maria Kaltenbach and Phillip Engler have contributed equally to this work. Areas of focal fatty sparing of the liver adjacent to the gallbladder and porta hepatis, absolute value of liver density less than 40 HU or a density difference greater than 25 HU between the spleen and liver on contrast-enhanced CT, increased echogenicity of the liver, attenuation of the ultrasound wave, loss of definition of the diaphragm, and poor delineation of the intrahepatic architecture on ultrasound and signal drop of liver parenchyma on the T1 weighted out of phase imaging on MRI was considered fatty liver [, A log binomial regression model was used to calculate adjusted relative risks. PubMed Become a Gold Supporter and see no third-party ads. Retrospective and prospective studies based on ultrasound have reported prevalence data for hepatic cysts of between 0.1% and 11.3% [7, 9, 23, 29]. and C.B.-M. contributed to the conception and design of the study. 1, 2, 3 Obika, M.; Noguchi, H. Diagnosis and evaluation of nonalcoholic fatty liver disease. Differential diagnosis 84.2% (n=16) of patients with adenoma were women. Despite its frequent association with liver injury, oxaliplatin is classically known to damage the liver via sinusoidal dilation and is thought to have a limited role in inducing steatohepatitis [, Since the FDA approval of capecitabine in 2001 as a chemotherapeutic agent, the oral route of 5-FU delivery became a mainstay of colorectal cancer treatment, alongside intravenous infusion. 2001;176 (2): 471-4. Hepatic steatosis is a benign condition characterized by diffuse or focal fatty infiltration of the liver parenchyma. HPB (Oxford) 7:186196, Department of Internal Medicine I, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany, Tanja Eva-Maria Kaltenbach,Phillip Engler,Wolfgang Kratzer,Suemeyra Oeztuerk,Thomas Seufferlein&Mark Martin Haenle, Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany, Zentraler Ultraschall, Klinik fr Innere Medizin I, Zentrum fr Innere Medizin, Universittsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany, You can also search for this author in the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, At least one of the lesions of interest was found in a total of 6851 patients (15.1% of the population examined). Variables found to be associated with both the exposure and outcome and thus, probably confounders, were selected as covariates based on a review of relevant literature. designed the study and conducted data collection. At the time the article was created Frank Gaillard had no recorded disclosures. [8, 17]. ; Lawson, T.L. The CEA level was 15.1 ng/ml and the cancer antigen 199 (CA199) level 167.4 U/ml. The understanding of hepatic adenoma has changed fundamentally in recent years [32, 33]. ; Kachura, J.J.; Vlachou, P.A. Marked increase in echogenicity with poor penetration of p. Demonstration of hepatic steatosis by computerized tomography in patients receiving 5-fluorouracil-based therapy for advanced colorectal cancer. ; Szczepaniak, L.S. The serum bilirubin and ammonia levels had recovered almost to normal by about five weeks after the operation and the patient was discharged on the 74th postoperative day. Recognition of this finding is important to prevent the erroneous belief that the region of sparing is itself a mass. The dynamic contrast enhancement techniques, CTA and dynamic MR imaging, showed irregular enhancement in the abnormal area, which indicated disappearance of the normal vessel structure and was quite useful for diagnosing the metastatic tumor. Patients with polycystic liver diseases were excluded from this study. The heart and lungs were clear to auscultation and palpation of the liver revealed no abnormality. Baseline and . 1. 5). Eur J Radiol 83:930934, Marin D, Galluzzo A, Plessier A, et al. In conclusion, the present case was difficult to diagnose because the tumor was hidden within the area of focal sparing, and dynamic contrast enhancement techniques, including CTA, CTAP and dynamic MRI, were useful for diagnosis. Focal hepatic steatosis. Lee, M.C.M. Haas, J.T. The research group of Koseoglu reported a prevalence of focal fatty sparing of up to 19.8 [18] Strunk et al. interesting to readers, or important in the respective research area. For more information, please refer to 2021. This distribution is the same as that seen in focal fatty sparing and is thought to relate to variations in vascular supply. Miyake, K.; Hayakawa, K.; Nishino, M.; Morimoto, T.; Mukaihara, S. Effects of oral 5-fluorouracil drugs on hepatic fat content in patients with colon cancer. Gut 32:677680, Caremani M, Vincenti A, Benci A, Sassoli S, Tacconi D (1993) Ecographic epidemiology of non-parasitic hepatic cysts. On MR images, the fatty area is hyperintense on T1- and T2-weighted images (not heavily on the latter). The mean age of patients at the time of the investigation was 5618.1years (range: 4months105years). In line with our results, all studies reported a higher prevalence of hepatic cysts with increasing age [19, 22, 23, 30]. In our study cohort, we did not observe a significant difference in the risk of developing steatosis when comparing patients receiving oxaliplatin-containing chemotherapy compared to those on a 5-FU based regimen (RR 0.64, 95% CI 0.30 to 1.38) after adjusting for sex, BMI, type 2 diabetes mellitus, hyperlipidemia, and steroid use (, The demographics of 135 patients who were treated with chemotherapy were summarized based on statin administration status, shown in, Among patients who were on statins at the time of their adjuvant chemotherapy, 11 of 37 (29.7%) patients developed steatosis within one year; however, 41 of 98 (41.8%) patients who did not receive statin treatment developed steatosis. Habib, M.B. Based on the results of our study, it is necessary to conduct prospective studies that involve a larger cohort of patients, who are controlled for comorbidities that may confound the association between CRC, statin use and the incidence of steatosis. Simple hepatic cysts and hemangiomas are the most common focal liver lesions. Volume 33, Issue 8 August 2014 Pages 1447-1452 Information Download PDF Ballestri, S.; Nascimbeni, F.; Baldelli, E.; Marrazzo, A.; Romagnoli, D.; Lonardo, A. NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk. The calculated prevalence of benign focal liver lesions shows that on the fortuitous discovery of space-occupying lesions of the liver, first consideration should be given to focal fatty sparing, simple hepatic cysts and hemangiomas. Macroscopic observation of the sliced resected specimen showed that the tumor was elliptic and not encapsulated, measuring 6.0 x 5.5 x 5.0 cm. Eur J Radiol 61:3343, Vaidyanathan S, Horrow MM (2007) Case 6: diagnosis: focal fatty sparing of the caudate lobe mimicking a mass. Histopathology of the resected liver tumor. 4) clearly showed a wedge-shaped hypointese area in the anterior segment, suggesting ischemia in this area. 4. In our study, this figure fell almost linearly with increasing age and amounted to only 66.8% in the group of patients over 70years of age. volume41,pages 2532 (2016)Cite this article. Geographic focal fat sparing, much like focal fat infiltration involves similar areas: gallbladder fossa, medial segment near the falciform ligament, and the porta hepatis (Fig 4 a).Nodular focal fat sparing presents as hypoechoic lesions in a diffusely echogenic liver and can be extremely difficult to differentiate from true mass lesions (Fig 4 b). 377/13). Peppercorn, P.; Reznek, R.; Wilzon, P.; Slevin, M.L. 1.1 Liver 1.2 Gallbladder and bile ducts 1.3 Pancreas 1.4 Spleen 1.5 Appendix 1.6 Gastrointestinal tract 1.7 Peritoneum mesentery and omentum 1.8 Various intra-abdominal tumors 1.9 Retroperitoneum and great vessels 1.10 Adrenal glands 1.11 Abdominal wall 1.12 Miscellaneous. View Frank Gaillard's current disclosures, View Raymond Chieng's current disclosures, see full revision history and disclosures, World Health Organisation 2001 classification of hepatic hydatid cysts, recurrent pyogenic (Oriental) cholangitis, combined hepatocellular and cholangiocarcinoma, inflammatory myofibroblastic tumour (inflammatory pseudotumour), portal vein thrombosis (acute and chronic), cavernous transformation of the portal vein, congenital extrahepatic portosystemic shunt classification, congenital intrahepatic portosystemic shunt classification, transjugular intrahepatic portosystemic shunt (TIPS), transient hepatic attenuation differences (THAD), transient hepatic intensity differences (THID), total anomalous pulmonary venous return (TAPVR), hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu disease), cystic pancreatic mass differential diagnosis, pancreatic perivascular epithelioid cell tumour (PEComa), pancreatic mature cystic teratoma (dermoid), revised Atlanta classification of acute pancreatitis, acute peripancreatic fluid collection (APFC), hypertriglyceridaemia-induced pancreatitis, pancreatitis associated with cystic fibrosis, low phospholipid-associated cholelithiasis syndrome, diffuse gallbladder wall thickening (differential), focal gallbladder wall thickening (differential), ceftriaxone-associated gallbladder pseudolithiasis, biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), intraductal tubulopapillary neoplasm (ITPN) of the bile duct, multiple biliary hamartomas (von Meyenburg complexes).

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