Correspondence
Hepatic Hemangioma
N Engl J Med 2000; 343:368-369August 3, 2000
- Article
To the Editor:
We disagree with the decision of Drs. Landor and Petrozzo (March 16 issue)1 to perform two additional radionuclide imaging studies “to confirm a presumptive diagnosis of hemangioma.” Hepatic hemangioma is typically an incidental finding, being present in 2 percent of the population. Computed tomography (CT) results in a specific diagnosis in nearly all cases, except those involving very small lesions.2 Large, cavernous hemangiomas often have a central scar or necrosis and have progressive, nodular or cloudlike enhancement, with the same degree of attenuation as is present in blood vessels.3 In our view, the CT features in the patient evaluated by Drs. Landor and Petrozzo were diagnostic and required no confirmatory tests. In some cases of atypical hemangioma, single-photon-emission CT technetium-99m–labeled red-cell scanning (or magnetic resonance imaging) can provide a valuable confirmation of the diagnosis. We do not believe that the single-photon-emission CT technetium-99m sulfur colloid scan provides useful information in this clinical setting.
3 ReferencesMichael P. Federle, M.D.
Giuseppe Brancatelli, M.D.
Arye Blachar, M.D.
University of Pittsburgh School of Medicine, Pittsburgh, PA 152131
Landor M ,Petrozzo P . Hepatic hemangioma. N Engl J Med 2000;342:791-791
Full Text | Web of Science | Medline2
Vilgrain V ,Boulos L ,Vullierme MP ,Denys A ,Terris B ,Menu Y . Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics 2000;20:379-397
Web of Science | Medline3
Quinn SF ,Benjamin GG . Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT. Radiology 1992;182:545-548
Web of Science | Medline
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