Periportal low attenuation associated with liver metastasis from colorectal cancer: evaluation using multi-detector-row CT with pathological correlation
Tóm tắt
Periportal low attenuation (PPLA) associated with metastatic liver cancer is occasionally seen on multi-detector-row CT (MDCT). The purpose of this study was to investigate the MDCT patterns of the PPLA and to correlate it with pathological findings. We retrospectively reviewed the MDCT images of 63 patients with metastatic liver cancers from colorectal adenocarcinoma. On MDCT scans, PPLA associated with liver metastasis was visualized in six patients with colorectal cancer. In these six patients who had undergone surgical resection, the radiologic-pathologic correlation was analyzed. All patients underwent a single contrast-enhanced MDCT within 1 month before surgical resection. The six liver cancers were pathologically proven to be moderately differentiated adenocarcinoma. We assessed the PPLA on MDCT concerning the distribution patterns and contrast enhancement with pathological correlation. In five of the patients, the PPLA extended to the hilar side from metastatic liver cancer. Pathologically, there was no cancer invasion into the intra-hepatic periportal area; however, massive lymphedema and fibrosis occurred in all six cases. PPLA on the hilar and peripheral sides of hepatic metastasis from colorectal cancer may be present suggesting lymphedema and fibrosis of portal tracts not always indicating cancer infiltration.
Tài liệu tham khảo
Lawson TL, Thorsen MK, Erickson SJ, Perret RS, Quiroz FA, Foley WD. Periportal halo: a CT sign of liver disease. Abdom Imaging. 1993;18:42–6.
Karcaaltincaba M, Haliloglu M, Akpinar E, Akata D, Ozmen M, Ariyurek M, et al. Multidetector CT and MRI findings in periportal space pathologies. Eur Radiol. 2007;61:3–10.
Puplim LF, Vilgrain V, Ronot M, Becker CD, Breguet R, Terraz S. Hepatic lymphatics: anatomy and related diseases. Abdom Imaging. 2015;40:1997–2011.
Siegel MJ, Herman TE. Periportal low attenuation at CT in childhood. Radiology. 1992;183:685–8.
Coakley FV, O’Reilly EM, Schwartz LW, Panicek DM, Castellino RA. Non-Hodgkin lymphoma as a cause of intrahepatic periportal low attenuation on CT. J Comput Assist Tomogr. 1997;21:726–8.
Mizukami Y, Ohta H, Arisato S, Nakano Y, Murakami M, Orii Y, et al. Case report: mucinous cholangiocarcinoma featuring a multicystic appearance and periportal collar in imaging. J Gastroenterl Hepatol. 1999;14:1223–6.
de Ridder J, de Wilt J, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget. 2016. doi:10.18632/oncotarget.10552.
Hallet J, Beyfuss K, Memeo R, Karanicolas PJ, Marescaux J, Pessaux P. Short and long-term outcomes of laparoscopic compared to open liver resection for colorectal liver metastases. Hepatobiliary Surg Nutr. 2016;5:300–10.
Alseidi A, Helton WS, Espat NJ. Does the literature support an indication for hepatic metastasectomy other than for colorectal primary? J Gastrointest Surg. 2006;10:99–104.
Ohtani O, Ohtani Y. Lymph circulation in the liver. Anat Rec. 2008;291:643–52.
Moore K, editor. Clinically oriented anatomy. 4th ed. Baltimore: Lippincott Williams and Wilkins; 1999.
Vidal-Vanaclocha F. The prometastatic microenvironment of the liver. Cancer Micro Environ. 2008;1:113–29.
Friedman SL. Hepatic stellate cells: protean, multifunctional, and enigmatic cells of the liver. Physiol Rev. 2008;88:125–72.
Yin C, Evason KJ, Asahina K, Stainier DY. Hepatic stellate cells in liver development, regeneration, and cancer. J Clin Investig. 2013;123:1902–10.
Krizhanovsky V, Yon M, Dickins RA, Hearn S, Simon J, Miething C, et al. Senescence of activated stellate cells limits liver fibrosis. Cell. 2008;134:657–67.
Bengtsson G, Carlsson G, Hafström L, Jönsson PE. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg. 1981;141:586–9.
Adam R, Vinet E. Regional treatment of metastasis: surgery of colorectal liver metastases. Ann Oncol 2004;15:iv103–6.
Cyrley SA, Izzo F. Radiofrequency ablation of primary and metastatic liver tumors. Surg Technol Int. 2002;10:99–106.
Chen MH, Yang W, Yan K, Gao W, Dai Y, Wang YB, et al. Treatment efficacy of radiofrequency ablation of 338 patients with hepatic malignant tumor and relevant complications. World J Gastroenterol. 2005;11:6395–401.
Takeuchi K, Kuwano H, Tsuzuki Y, Ando T, Sekihara M, Hara T, et al. Clinicopathological characteristics of poorly differentiated adenocarcinoma of the colon and rectum. Hepatogastroenterology. 2004;51:1698–702.
Chung CK, Zaino RJ, Stryker JA. Colorectal carcinoma: evaluation of histologic grade and factors influencing prognosis. J Surg Oncol. 1982;21:143–8.
International Union Against Cancer (UICC). Histopathological grading. In: Sobin LH, Wittekind C, editors. TNM classification of malignant tumors, vol. 13. 6th ed. New York: Wiley-Liss; 2002.