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Calcified intrahepatic portal vein thrombus: distinction from intrahepatic choledocholithiasis
R J Balotin1, H P McAdams, A H Dachman
1Department of Radiology, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Insights
Calcified portal vein thrombus can mimic intrahepatic masses on CT scans. This unusual cause presents as a branching calcified lesion, requiring careful differentiation from other conditions like bile duct stones.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Intrahepatic portal vein thrombus is a rare condition.
- Calcified lesions in the liver can present diagnostic challenges.
- Distinguishing between vascular and biliary causes of intrahepatic masses is crucial.
Observation:
- Computed tomography (CT) revealed a calcified intrahepatic mass with a branching morphology.
- Peripheral enhancement was noted after dynamic bolus contrast administration.
- The lesion's appearance mimicked other intrahepatic pathologies.
Findings:
- The patient had a calcified intrahepatic portal vein thrombus.
- Cholangiography confirmed the absence of intrahepatic choledocholithiasis (bile duct stones).
- CT findings were consistent with a calcified thrombus rather than a biliary stone.
Implications:
- Calcified portal vein thrombus is an uncommon etiology for intrahepatic calcified masses.
- Radiologists should consider this diagnosis in cases of branching calcified intrahepatic lesions on CT.
- Accurate diagnosis is essential for appropriate patient management and treatment.
Abstract:
In a case of calcified intrahepatic portal vein thrombus CT demonstrated a branching calcified intrahepatic mass with peripheral enhancement following dynamic bolus contrast medium administration. The distinction from intrahepatic choledocholithiasis was made with normal cholangiography. Calcified portal vein thrombus should be considered an unusual cause of branching calcified intrahepatic mass on CT.