Localized peliosis of the adult liver in combination with type I glycogen storage disease

The diagnostic evaluation of peliosis hepatis by means of CT, ultrasonography or liver scintiscanning poses serious problems, as very often the lesions are detectable only angiographically and appear as up to a maximum of 1 cm large contrast medium deposits in the late arterial phase. Even in angiography, localized peliosis may look like a cavitary hemangioma in particular, and also but less frequently, like liver adenoma or localized, nodular hyperplasia. In the case of localized lesions, ultrasonography does not yield differential diagnostic results to exclude metastatic processes. The CT image likewise may present a noncharacteristic accumulation pattern, so that any diagnosis in combination with anamnesic data (as e.g. application of steroid hormones) will remain tentative. Clear differentiation in the CT sometimes only is possible subsequent to fatty infiltrations into the focal lesions. Diffuse lesions cannot be discerned from diffuse hemangiomatosis. A safe diagnosis is only obtainable by histologie examination, but laparoscopy is a helpful tool, too. (MG)