Presentation
Fall from standing height. Rib fractures and pneumothorax.
Patient Data
There is a tubular, round-edged structure arising from the caudate of the liver and extending medially adjacent to the posterior surface of the stomach and superior surface of the pancreatic body. It is homogeneous and continuous with the liver, suggesting a prominent papillary process of the caudate lobe.
Also noted are subcutaneous emphysema and multiple calcified gallstones.
Annotated axial image highlights in purple the elongated papillary process of the caudate lobe.
Case Discussion
There is a prominent papillary process of the caudate lobe. The importance of this finding is in not confusing it with a hepatic or pancreatic neoplasm, or a retroperitoneal lymph node. The homogenous appearance, the isodensity to the liver, as well as the smooth edges of transition with the lateral caudate lobe are the keys to making this distinction. In addition, the absence of a dysmorphic liver parenchyma make an exophytic tumor very unlikely.
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