Regenerative nodes

Sonographic findings in liver cirrhosis are polymorphic on account of the vastly differing individual hepatic structures (loss of parenchyma, regenerative nodes, connective tissue, fat depositions, compressed hepatic veins, etc.), (s. figs. 6.6, 6.7)... 

FNH is the second most frequent benign hepatic tumour. It is a pseudotumorous regenerative node, most frequently occurring in women. Four-phase cholescintigra-phy using Tc-IDA is currently the best method of detection. In 80-90% of cases, perfusion is good with hypervascular tumours of > 2—3 cm in diameter. This results in initial enhancement of the FNH. However, the... 

Tumour-like lesions include hamartoma, FNH, NRH, focal steatosis, peliosis hepatis, inflammatory pseudotumour, cysts, lobular hyperplasia, postnecrotic regenerative nodes, etc. 

In the course of massive subacute liver necrosis (or hepatic dystrophy), large parts of the hepatic parenchyma can be destroyed within a few months. Extensive regenerative nodes form from the remaining epithelium. Within these regenerations, the lobular architecture is either still maintained or has been partially restored. Areas of parenchymal loss are converted into fibre-dense scar tissue with embedded pseudoductuli and duct proliferations as well as irregularly located residual hepatocytes. This course is extremely rare. In the literature, it is also called incomplete postnecrotic cirrhosis. 

Fig. 35.13 Cirrhosis with regenerative node ("4=), recanalized umbihcal vein (= caput Medusae) (- ) and ascites ( ) in CT...

Focal nodular hyperplasia (FNH) Nodular regenerative hyperplasia (NRH) Regenerative nodes... 

A particular hepatotropicity causing severe herpes hepatitis is ascribed to herpesvirus 6 (HHV-6). There have even been reports of a fulminant course with this virus infection. (18, 23, 35) HHV-8 causes Kaposi s sarcoma. The liver is the most common site, with dark reddish-violet tumour nodes. Histological analysis reveals endothelial cell proliferations and growths of spindle-shaped fibroblast-like cells. The bile ducts may be altered. Transaminase levels are elevated, and jaundice occurs. There may be a causal relationship between HHV-8 infection and multicentric Castlemans disease. The latter usually implies the presence of peliosis hepatis, perisi-nusoidal fibrosis and nodular regenerative hyperplasia. 

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