case_images: PMC4168547_01
case_images: Dr. Alexandre Batista
case_images: JCIS-4-43-g001.jpg
case_images: PMC4168547_01_JCIS-4-43-g001.jpg
case_images: F1
case_images: 68-year-old male referred to our hospital due to multifocal hepatic lesions, subsequently diagnosed as diffuse hepatic hemangiomatosis. a) Ultrasound examination demonstrates multiple ill-defined yperechoic nodules dispersed throughout the hepatic parenchyma, mostly sub-centimeter and with right hemi-liver predominance. Some nodules are larger and better defined (arrows). b) Color Doppler shows no evident vascularity in the lesion.
case_images: JCIS-4-43-g002.jpg
case_images: PMC4168547_01_JCIS-4-43-g002.jpg
case_images: F2
case_images: A discontinuous centripetal filling appearance was noted on larger lesions [Figure 2].
case_images: 68-year-old male referred to our hospital due to multifocal hepatic lesions, subsequently diagnosed as diffuse hepatic hemangiomatosis. a) Axial fatsaturated T2-weighted image shows countless small-sized moderately bright lesions (arrows). b) Diffusion weighted image shows these lesions with high signal intensity (b = 600 sec/mm2) (arrows), which may be seen in liver hemangiomas secondary to T2 shine-through effect. Axial c) pre-contrast and (d-f) post-contrast fat-saturated T1-weighted images show arterial homogeneous enhancement (arrows, d), some exhibiting portal phase peripheral nodular enhancement (arrow, e) and late centripetal filling (arrows, f).
case_images: JCIS-4-43-g003.jpg
case_images: PMC4168547_01_JCIS-4-43-g003.jpg
case_images: F3
case_images: Pathology revealed endothelial-lined sinusoidal proliferation with erythrocyte content, consistent with hepatic hemangiomatosis [Figure 3].