Hepatic amyloidosis
Citation, DOI, disclosures and article data
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosuresAt the time the article was last revised Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosures- Liver amyloidosis
- Amyoidosis of the liver
- Amyoidosis involving the liver
Hepatic amyloidosis refers to the extracellular deposition of amyloid in the parenchyma sinusoids or vessel walls. Liver involvement in amyloidosis is uncommon.
On this page:
Pathology
It can be primary or secondary and it typically occurs as diffuse infiltration 2.
There is amyloid deposition in liver parenchyma which occurs along the sinusoids within the space of Disse, or in blood vessel walls. Hepatocytes can be markedly compressed by extensive accumulation of amyloid and they may atrophy or nearly disappear.
In advanced cases with massive infiltration, the liver is enlarged with a rubbery elastic consistency, and it may show 'lardaceous liver' appearance.
Radiographic features
Hepatomegaly and heterogeneous appearances of the liver parenchyma are the most common, though nonspecific, imaging features 7.
Ultrasound
Non-specific and may show heterogeneous hepatic echotexture 3 or diffuse or focal areas of low attenuation 7. Prominent calcifications can be rarely seen.
CT
There can be hepatomegaly with decreased hepatic attenuation 2. Some calcification may be present.
MRI
- T1: has increased signal through the liver 1,3
- T2: little change 3
Differential diagnosis
For CT appearances of decreased hepatic attenuation: see causes of decreased hepatic attenuation.
References
- 1. Shin Y. Hepatic Amyloidosis. Korean J Hepatol. 2011;17(1):80. doi:10.3350/kjhep.2011.17.1.80
- 2. Georgiades C, Neyman E, Barish M, Fishman E. Amyloidosis: Review and CT Manifestations. Radiographics. 2004;24(2):405-16. doi:10.1148/rg.242035114
- 3. Son R, Chang J, Choi J. Primary Hepatic Amyloidosis: Report of an Unusual Case Presenting as a Mass. Korean J Radiol. 2011;12(3):382. doi:10.3348/kjr.2011.12.3.382
- 4. MØller J, Santoni-Rugiu E, Chabanova E, Løgager V, Hansen A, Thomsen H. Magnetic Resonance Imaging with Liver-Specific Contrast Agent in Primary Amyloidosis and Intrahepatic Cholestasis. Acta Radiol. 2007;48(2):145-9. doi:10.1080/02841850601128959
- 5. Suzuki S, Takizawa K, Nakajima Y, Katayama M, Sagawa F. CT Findings in Hepatic and Splenic Amyloidosis. J Comput Assist Tomogr. 1986;10(2):332-4. doi:10.1097/00004728-198603000-00034
- 6. Marmolya G, Karlins N, Petrelli M, McCullough A. Unusual Computed Tomography Findings in Hepatic Amyloidosis. Clin Imaging. 1990;14(3):248-50. doi:10.1016/0899-7071(90)90084-o
- 7. Ozcan H, Haliloglu M, Sokmensuer C, Akata D, Ozmen M, Karcaaltincaba M. Imaging for Abdominal Involvement in Amyloidosis. Diagn Interv Radiol. 2017;23(4):282-5. doi:10.5152/dir.2017.16484
Incoming Links
Related articles: Pathology: Hepato-Pancreato-Biliary
- liver
- depositional disorders
- infection and inflammation
- liver abscess
- hepatic hydatid infection
- cirrhosis
- hepatitis
- cholecystitis
- cholangitis
- malignancy
- liver and intrahepatic bile duct tumors
- benign epithelial tumors
- hepatocellular hyperplasia
- hepatocellular adenoma
- hepatic/biliary cysts
- benign nonepithelial tumors
- primary malignant epithelial tumors
- hepatocellular carcinoma
- hepatocellular carcinoma variants
-
cholangiocarcinoma
- intra-hepatic
- mass-forming type
- periductal infiltrating type - Klatskin tumors
- intraductal growing type
- extra-hepatic/large duct type
- intra-hepatic
- biliary cystadenocarcinoma
- combined hepatocellular and cholangiocarcinoma
- hepatoblastoma
- undifferentiated carcinoma
- primary malignant nonepithelial tumors
- hematopoietic and lymphoid tumors
- primary hepatic lymphoma
- hepatic myeloid sarcoma (hepatic chloroma)
- secondary tumors
- miscellaneous
- adrenal rest tumors
- hepatic carcinosarcoma
- hepatic fibroma
- hepatic hemangioma
- hepatic Kaposi sarcoma
- hepatic lipoma
- hepatic mesenchymal hamartoma
- hepatic myxoma
- hepatic rhabdoid tumor
- hepatic solitary fibrous tumor
- hepatic teratoma
- hepatic yolk sac tumor
- inflammatory myofibroblastic tumor (inflammatory pseudotumor)
- nodular regenerative hyperplasia
- pancreatic rest tumors
- primary hepatic carcinoid
- benign epithelial tumors
- liver and intrahepatic bile duct tumors
- metabolic
- trauma
-
vascular and perfusion disorders
- portal vein related
- hepatic artery related
- hepatic veins related
- inferior vena cava related
- other
- third inflow
- liver thrombotic angiitis
- infra diaphragmatic total anomalous pulmonary venous return (TAPVR)
- hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease)
- pancreas
-
pancreatic neoplasms
- cystic neoplasm (cystic pancreatic mass differential diagnosis)
- solid neoplasm
- non-epithelial pancreatic neoplasms
- others
- simple pancreatic cyst
-
pancreatitis (mnemonic for the causes)
- acute pancreatitis
- chronic pancreatitis
- Ascaris-induced pancreatitis
- tropical pancreatitis
- autoimmune pancreatitis
- emphysematous pancreatitis
- hypertriglyceridemia-induced pancreatitis
- hereditary pancreatitis
- pancreatitis associated with cystic fibrosis
- pancreaticopleural fistula
- segmental pancreatitis
- pancreatic atrophy
- pancreatic lipomatosis
- pancreatic trauma
- pancreatic transplant
-
pancreatic neoplasms
- gallbladder and biliary
- congenital malformations and anatomical variants
- gallstones
- gallbladder inflammation
- bile ducts inflammation
- gallbladder wall abnormalities
- other gallbladder abnormalities
- bile duct dilatation (differential)
- bile duct wall thickening (differential)
- bile ducts neoplasms