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Hepatic Nodularity Not Indicative of Cirrhosis

In hepatic failure, nodularity indicates alternating foci of confluent regenerative nodules, necrosis

MONDAY, Oct. 27 (HealthDay News) -- Hepatic surface nodularity is not a consistent sign of cirrhosis in patients with fulminant hepatic failure and should not be utilized as diagnosis criteria in this setting, according to a report in the November issue of Radiology.

Jason A. Poff, M.D., of the University of California San Francisco and colleagues prospectively examined the incidence and histopathologic basis of hepatic surface nodularity at imaging in 35 consecutive patients who developed fulminant hepatic failure and underwent liver transplant.

None of the 15 patients demonstrating hepatic surface nodularity at pre-transplant imaging was diagnosed with cirrhosis at histopathologic examination, while only one patient with a smooth liver surface was diagnosed with cirrhosis. More patients with hepatic surface nodularity seen on pre-transplant imaging than those with smooth liver surfaces had the histopathologic finding of a combination of alternating foci of confluent regenerative nodules and necrosis (86 percent versus 5 percent). They also had a longer illness duration (31 days versus 13 days) and lower maximum liver biochemical indices.

"In conclusion, hepatic surface nodularity is commonly seen at imaging in fulminant hepatic failure and usually reflects a combination of alternating foci of confluent regenerative nodules and necrosis rather than cirrhosis; this is important because an erroneous radiologic diagnosis of cirrhosis in this setting could adversely affect transplantation status," the authors write.

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