Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content.
<h4>Background</h4>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...
| _version_ | 1826574290315640832 |
|---|---|
| author | Willemijn M Klein Lianne J P Sonnemans Sabine Franckenberg Barbara Fliss Dominic Gascho Mathias Prokop Wouter H Lamers Jill P J M Hikspoors Michael J Thali Patricia M Flach |
| author_facet | Willemijn M Klein Lianne J P Sonnemans Sabine Franckenberg Barbara Fliss Dominic Gascho Mathias Prokop Wouter H Lamers Jill P J M Hikspoors Michael J Thali Patricia M Flach |
| author_sort | Willemijn M Klein |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| first_indexed | 2024-12-20T19:25:27Z |
| format | Article |
| id | doaj.art-b8266f0eba81499c866e5556808982a9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-14T12:56:27Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b8266f0eba81499c866e5556808982a92025-03-02T05:32:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01151e022154410.1371/journal.pone.0221544Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content.Willemijn M KleinLianne J P SonnemansSabine FranckenbergBarbara FlissDominic GaschoMathias ProkopWouter H LamersJill P J M HikspoorsMichael J ThaliPatricia M Flach<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0221544/1/pone.0221544.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210219%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210219T204524Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
| spellingShingle | Willemijn M Klein Lianne J P Sonnemans Sabine Franckenberg Barbara Fliss Dominic Gascho Mathias Prokop Wouter H Lamers Jill P J M Hikspoors Michael J Thali Patricia M Flach Pseudolesion in the right parafissural liver parenchyma on CT: The base is found in embryology and collagen content. PLoS ONE |
| 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 |
| url | https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0221544/1/pone.0221544.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210219%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210219T204524Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 |
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