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전이성 간세포 암종과 감별이 필요했던 굴모양 혈관 확장증 2예
현종훈 ( Jong Hoon Hyun ),조유경 ( Yoo Kyung Cho ),송현주 ( Hyun Joo Song ),최은광 ( Eun Kwang Choi ),현창림 ( Chang Lim Hyun ),권정미 ( Jung Mi Kwon ),김봉수 ( Bong Soo Kim ),송병철 ( Byung Cheol Song ) 대한소화기학회 2014 대한소화기학회지 Vol.64 No.4
Hepatic sinusoidal dilatation is a rare benign vascular disorder characterized by focal dilatation of the sinusoidal spaces. In most cases, the underlying etiology is unclear but it may be related to the impairment of venous outflow or sinusoidal infiltration by diverse causes. Diagnosing hepatic sinusoidal dilatation based soley on imaging study is not easy since there are no pathognomonic radiologic findings indicative of this condition. Recently, the authors experience two cases of hepatic sinusoidal infiltration. The first patient was a 53-year-old man detected to have multiple hepatic nodules on ultrasonography (US) during a routine medical check-up. The second patient was an 82-year-old woman with abdominal discomfort who was referred from local clinic with high suspicion of hepatic metastases on US. In both cases, CT scan demonstrated multiple nodules with rim enhancement on arterial phase that became iso-dense to adjacent liver parenchyma on delayed phase. On MRI, these nodules showed rim enhancement on arterial phase, had high signal intensity on T2 weighted images, and became iso-intense with partial defect on hepatobiliary phase. Because imaging studies could not exclude the presence of hepatic metastases, liver biopsy was performed and it demonstrated hepatic sinusoidal dilatation with well preserved reticulin fiber without any evidence of malignancy. Herein, we report two cases of idiopathic hepatic sinusoidal dilatation mimicking hepatic metastases. (Korean J Gastroenterol 2014;64:239-245)