331.文献摘读：Radiologic Mimics of Cirrhosis（3）

每天朗读一段医学影像学英语文章

Multifocal retraction of the liver capsule and enlargement of the caudate lobe also can be seen in this setting. The histopathologic or pathophysiologic basis of these changes is not well understood, and the prefix “pseudo-” may be a misnomer because these patients can develop features of portal hypertension such as portosystemic venous collaterals and bland ascites (Figs. 1A, 1B and 2A, 2B). Why this phenomenon seems almost specific for breast cancer (Fig. 3A, 3B) remains unclear, with only sporadic reports of these changes in other primary malignancies with liver metastases。

Fig. 2A —59-year-old woman with multiple hypodense biopsy-proven hepatic metastases from invasive ductal carcinoma of breast. Axial contrast-enhanced CT image obtained before patient started chemotherapy.

Fig. 2B —59-year-old woman with multiple hypodense biopsy-proven hepatic metastases from invasive ductal carcinoma of breast. Axial contrast-enhanced CT image obtained 6 months after A—that is, after patient had started chemotherapy—shows diffuse hepatic nodularity, bland ascites (asterisk), esophageal varices (arrow), and partial regression of hepatic metastases. Findings are of pseudocirrhosis of treated breast cancer metastases; however, without prior studies and clinical history, these findings could suggest diagnosis of cirrhosis.

Fig. 3A —68-year-old woman who presented for imaging after receiving two cycles of chemotherapy for hepatic metastases thought to be from primary pancreatic carcinoma. Axial contrast-enhanced CT image shows liver surface is coarsely lobulated with several irregular hypodense parenchymal lesions. Appearance was considered suggestive of pseudocirrhosis, casting doubt on diagnosis of pancreatic cancer.

Fig. 3B —68-year-old woman who presented for imaging after receiving two cycles of chemotherapy for hepatic metastases thought to be from primary pancreatic carcinoma. Axial contrast-enhanced image obtained at more superior level than A shows small hypervascular lesion (arrow) in right breast. Further workup including resection of breast mass confirmed diagnosis of metastatic breast cancer.

Notes:

1. portosystemic /ˌpɔtosɪs'timɪk/ adj. 门体静脉的

2. collateral /kə'lætərəl/ n. 附属担保品 adj. 相关的

3. ascites /ə'saɪtiz/ n. [医]腹水

4. sporadic /spə'rædɪk/ adj. 零星的；分散的；不定时发生的

5. esophageal /ˌi:sə'fædʒiəli:,sɔfə'dʒi:əl/ adj. 食道的,食管的

6. varices /'vɛrɪ,siz/ n. [医]静脉曲张

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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