Multiple hepatic adenomas: Tc-99m RBC liver SPECT findings with pathologic correlation.
A 24-year-old man with multiple hepatic masses incidentally detected by ultrasonography underwent Tc-99m RBC liver SPECT. SPECT images showed increased blood pooling mimicking hemangiomas in two of four masses or activity similar to normal liver in the others. The patient had a 3-year history of steroid therapy for rheumatoid arthritis. Computed tomography and magnetic resonance imaging showed multiple liver lesions. Angiography revealed three hypervascular and one hypovascular mass. Microscopic examination of the enucleated specimens disclosed hepatic adenomas with many dilated sinusoids in the masses showing blood pooling and fatty change, and adenomas without dilated sinusoids in the masses not showing blood pooling. This case report shows that the appearance of hepatic adenomas can vary on Tc-99m RBC liver SPECT, depending on whether dilated sinusoid and hepatic adenomas show blood pooling. This is one of the few examples of false-positive findings that can be mistaken for hemangioma.
Lim
Seok Tae
ST
Department of Nuclear Medicine, Institute for Medical Sciences, Chonbuk National University Medical School, 634-18 Kaumann-dong, Duckjin-gu, Chonju, Chonbuk 561-712, Korea.
Sohn
Myung-Hee
MH
Kwak
Jae-Yong
JY
Yim
Chang-Yeol
CY
D000236:Adenoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D015901:Angiography, Digital Subtraction; D003937:Diagnosis, Differential; D004912:Erythrocytes; D006391:Hemangioma / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D013667:Technetium