A Case of a Primary Hepatic Tumor Causing Segmental Changes on Imaging and Its Relation to Zahns Infarct

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概要

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• A 69-year-old female was admitted to our hospital for further examination of an intrahepatic mass which had been found while undergoing a complete physical examination. The mass measured 4 cm in size and was located in the medial segment (S<SUB>4</SUB>) of the liver. On computed tomography (CT), S<SUB>4</SUB> was observed to be atrophied and was well enhanced segmentally. A celiac angiogram showed segmental staining, and a transarterial portogram demonstrated portal stoppage of S<SUB>4</SUB> from the left branch. However, no segmental intensity difference was seen on magnetic resonance imaging (MRI). An aspiration biopsy showed adenocarcinoma and thus an operation was performed under a tentative diagnosis of intrahepatic cholangiocarcinoma. The postoperative diagnosis of the tumor was combined hepatocellular and cholangiocellular carcinoma. However, no histological abnormality was seen in S<SUB>4</SUB>, contrary to the expectation of Zahns infarct. In this study, we discuss the mechanism and imaging findings of Zahns infarct, the possible reasons as to why no pathological change was seen in S<SUB>4</SUB>, as well as stress the rarity of reports on Zahns infarct in cases of portal thrombus due to hepatocellular carcinoma.

著者

• Sugihara Shigetaka

  Department Of Pediatrics Chiba University School Of Medicine

• Ide Koichi

  Department Of Radiology Higashi-osaka City General Hospital

• Nozaki Yoshimi

  Section Of Diagnostic Radiology St. Mary's Hospital

• Nishihara Harumi

  Section Of Diagnostic Radiology St. Mary's Hospital

• Hayabuchi Naofumi

  Department Of Radiology Kurume University Hospital

• Nishimura Hiroshi

  Department Of Applied Chemistry Faculty Of Engineering Osaka Institute Of Technology

• Kage Masayoshi

  Department Of Diagnostic Pathology Kurume University Hospital

• FUNATSU KAZUHIRO

  Section of Diagnostic Radiology

• TABUCHI EMI

  Section of Diagnostic Radiology

• TAKANO KOICHI

  Section of Diagnostic Radiology

• KATSURAGI MAKOTO

  Section of Diagnostic Radiology

• UCHINO YOSHIHIKO

  Surgery St. Mary's Hospital

• TOMODA NOBUYUKI

  Surgery St. Mary's Hospital

• ITO YUJI

  Pathology, St. Mary's Hospital

• UCHINO YOSHIHIKO

  Surgery St. Mary's Hospital

• IDE KOICHI

  Departments of Gastroenterology

• KAGE MASAYOSHI

  Departments of Pathology, Kurume University School of Medicine

• ITO YUJI

  Pathology, St. Mary's Hospital

• TOMODA NOBUYUKI

  Surgery St. Mary's Hospital

• NOZAKI YOSHIMI

  Section of Diagnostic Radiology

• NISHIHARA HARUMI

  Section of Diagnostic Radiology

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