Hyperplastic nodular hepatic lesions following end-to-side portacaval shunting in childhood.
We describe a 48-year-old man with nodular intrahepatic lesions accompanied by communication between the inferior vena cava and portal systems as well as absence of intrahepatic portal veins. After infection with malaria in childhood, end-to-side portacaval shunting had been performed to treat upper gastrointestinal bleeding at the age of 15 years. A biopsy specimen obtained under ultrasonographic guidance showed hyperplastic nodules suggestive of focal nodular hyperplasia. The estradiol concentration in the blood was elevated (55 pg/ml). This case suggests that portacaval shunting may be associated with hyperplastic liver nodules through hyperestrogenemia and abnormal hepatic hemodynamics.
Fukushima
Nobuyoshi
N
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine. kingsno1@med.kurume-u.ac.jp
Kuromatsu
Ryoko
R
Uchiyama
Daiji
D
Itano
Satoshi
S
Takata
Akio
A
Ando
Eiji
E
Sumie
Shuji
S
Torimura
Takuji
T
Uchida
Masafumi
M
Nakashima
Osamu
O
Kojiro
Masamichi
M
Sata
Michio
M
D004958:Estradiol / Q000097:blood; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis / Q000209:etiology; D008099:Liver / Q000098:blood supply / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects*
D004958:Estradiol