Multiple comet tail artifacts in the liver: a case of congenital hepatic fibrosis showing unusual biliary appearance.
Congenital hepatic fibrosis (CHF) is a form of autosomal recessive polycystic kidney disease. Because of the common underlying pathophysiology of ductal plate malformation, CHF can be accompanied by an abnormal biliary appearance, which is characterized by a saccular or fusiform dilatation of the bile ducts. We encountered the case of a 35-year-old man suffering from CHF concomitant with esophageal varices, which were treated by endoscopic sclerotherapy. The patient had elevated serum concentrations of alkaline phosphatase and γ-glutamyl transpeptidase without apparent biliary disease, including hepatolithiasis or a history of cholangitis. Magnetic resonance cholangiography showed an abnormal biliary appearance, which was not saccular or fusiform but had multiple stenosis with unknown causes. B-mode sonogram showed multiple comet tail artifacts in the liver parenchyma, probably corresponding to the compact fibrosis bands and bile in the bile duct as well as peripheral bile duct dilatation, which was proven pathologically. We propose that multiple comet tail artifacts in the liver may suggest the presence of a bile duct abnormality in patients with CHF, suggesting the potential risk for developing biliary complications.
The Clinical Laboratory, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan.
Michiko
M
Kuwano
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan. maru@faculty.chiba-u.jp.
Hitoshi
H
Maruyama
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.
Takayuki
T
Kondo
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.
Tadashi
T
Sekimoto
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.
Taro
T
Shimada
The Clinical Laboratory, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan.
Shuichi
S
Yamamoto
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.
Toshio
T
Tuyuguchi
Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8670, Japan.
Osamu
O
Yokosuka
The Clinical Laboratory, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba, 260-8677, Japan.
Fumio
F
Nomura
D000328:Adult; D016477:Artifacts; D001652:Bile Ducts / Q000000981:diagnostic imaging; D030342:Genetic Diseases, Inborn / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008297:Male; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
Comet tail artifact; Congenital hepatic fibrosis; Liver