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Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content
BACKGROUND: Computed tomography (CT) images of livers may show a hypo-attenuated structure alongside the falciform ligament, which can be a focal fatty pseudolesion and can mimic a malignancy. The preferred location is on the right parafissural site, ventral in segment IVa/b. The etiology is not cle...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984698/ https://www.ncbi.nlm.nih.gov/pubmed/31986149 http://dx.doi.org/10.1371/journal.pone.0221544 |
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author | Klein, Willemijn M. Sonnemans, Lianne J. P. Franckenberg, Sabine Fliss, Barbara Gascho, Dominic Prokop, Mathias Lamers, Wouter H. Hikspoors, Jill P. J. M. Thali, Michael J. Flach, Patricia M. |
author_facet | Klein, Willemijn M. Sonnemans, Lianne J. P. Franckenberg, Sabine Fliss, Barbara Gascho, Dominic Prokop, Mathias Lamers, Wouter H. Hikspoors, Jill P. J. M. Thali, Michael J. Flach, Patricia M. |
author_sort | Klein, Willemijn M. |
collection | PubMed |
description | BACKGROUND: Computed tomography (CT) images of livers may show a hypo-attenuated structure alongside the falciform ligament, which can be a focal fatty pseudolesion and can mimic a malignancy. The preferred location is on the right parafissural site, ventral in segment IVa/b. The etiology is not clear, nor is it known how the histology of this location develops. These are evaluated in this study. METHODS: 40 adult cadavers with autopsy and / or postmortem CT in a university hospital and a forensic center were included. Liver biopsies were taken at the left side of the falciform ligament as control, and at the right side as the possible precursor of a pseudolesion; these were examined for collagen and fat content. Cadavers with steatotic (>5% fat) or fibrotic (>2% collagen) control samples were excluded. RESULTS: Significantly more collagen was present in the right parafissural liver parenchyma: median 0.68% (IQR: 0.32–1.17%), compared to the left side 0.48% (IQR: 0.21–0.75%) (p 0.008), with equal fat content and CT attenuation values. The etiophysiology goes back to the demise of the umbilical venes in the early embryonic and neonatal period. CONCLUSIONS: The right parafissural area contains more collagen and an equal amount of fat compared to the control left side. This supports the hypothesis of delayed, ‘third’ inflow: the postnatal change in blood supply from umbilical to portal leaves the downstream parafissural area hypoperfused leading to hypoxia which in turn results in collagen accumulation and the persistence of paraumbilical veins of Sappey. |
format | Online Article Text |
id | pubmed-6984698 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-69846982020-02-07 Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content Klein, Willemijn M. Sonnemans, Lianne J. P. Franckenberg, Sabine Fliss, Barbara Gascho, Dominic Prokop, Mathias Lamers, Wouter H. Hikspoors, Jill P. J. M. Thali, Michael J. Flach, Patricia M. PLoS One Research Article BACKGROUND: Computed tomography (CT) images of livers may show a hypo-attenuated structure alongside the falciform ligament, which can be a focal fatty pseudolesion and can mimic a malignancy. The preferred location is on the right parafissural site, ventral in segment IVa/b. The etiology is not clear, nor is it known how the histology of this location develops. These are evaluated in this study. METHODS: 40 adult cadavers with autopsy and / or postmortem CT in a university hospital and a forensic center were included. Liver biopsies were taken at the left side of the falciform ligament as control, and at the right side as the possible precursor of a pseudolesion; these were examined for collagen and fat content. Cadavers with steatotic (>5% fat) or fibrotic (>2% collagen) control samples were excluded. RESULTS: Significantly more collagen was present in the right parafissural liver parenchyma: median 0.68% (IQR: 0.32–1.17%), compared to the left side 0.48% (IQR: 0.21–0.75%) (p 0.008), with equal fat content and CT attenuation values. The etiophysiology goes back to the demise of the umbilical venes in the early embryonic and neonatal period. CONCLUSIONS: The right parafissural area contains more collagen and an equal amount of fat compared to the control left side. This supports the hypothesis of delayed, ‘third’ inflow: the postnatal change in blood supply from umbilical to portal leaves the downstream parafissural area hypoperfused leading to hypoxia which in turn results in collagen accumulation and the persistence of paraumbilical veins of Sappey. Public Library of Science 2020-01-27 /pmc/articles/PMC6984698/ /pubmed/31986149 http://dx.doi.org/10.1371/journal.pone.0221544 Text en © 2020 Klein et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Klein, Willemijn M. Sonnemans, Lianne J. P. Franckenberg, Sabine Fliss, Barbara Gascho, Dominic Prokop, Mathias Lamers, Wouter H. Hikspoors, Jill P. J. M. Thali, Michael J. Flach, Patricia M. Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title | Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title_full | Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title_fullStr | Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title_full_unstemmed | Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title_short | Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content |
title_sort | pseudolesion in the right parafissural liver parenchyma on ct: the base is found in embryology and collagen content |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984698/ https://www.ncbi.nlm.nih.gov/pubmed/31986149 http://dx.doi.org/10.1371/journal.pone.0221544 |
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