Variants and Pseudotumors Simulating Disease

  • W. Jaschke
Conference paper
Part of the Syllabus book series (SYLLABUS)


Several factors influence the interpretation of imaging studies, for example, the use of an adequate imaging protocol, the choice of the imaging modality and knowledge of the normal anatomy and of anatomic variants. In abdominal imaging there are three important pitfalls which have to be discussed:
  • First, anatomic variants may simulate an abdominal tumor which may result in unnecessary diagnostic tests or even unneccessary surgery.

  • Second, artefacts and inadequate identification of normal structures can simulate an abdominal tumor (“pseudotumor”).

  • Third, benign lesions which are harmless and require no further workup or treatment may be mistaken for malignant lesions and, thus, cause erroneous therapeutic decisions.


Chronic Pancreatitis Spiral Compute Tomography Magn Reson Image Cavernous Hemangioma Situs Inversus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Suggested Reading

  1. Alper H, et al. (1996) Pulmonary aplasia: MR angiography findings. Eur Radiol 6(1):89–91PubMedCrossRefGoogle Scholar
  2. Bjornskov I, et al. (1997) Cystic gastric leiomvoma — a diagnostic pitfall. Acta Gastroenterol Belg 60(3):238–239PubMedGoogle Scholar
  3. Blanchard DG, et al. (1998) Infrahepatic interruption of the inferior vena cava with azygos continuation: A potential mim-icker of aortic pathology. J Am Soc Echocardiogr 11(11):1078–1083PubMedCrossRefGoogle Scholar
  4. Borgonovo G, et al. (1998) Pseudotumor of the liver: a challenging diagnosis. Hepatogastroenterology 45(23): 1770–1773PubMedGoogle Scholar
  5. Dougherty MJ, et al. (1996) Congenitally absent inferior vena cava presenting in adulthood with venous stasis and ulceration: a surgically treated case. J Vasc Surg 23(1):141–146PubMedCrossRefGoogle Scholar
  6. Dubowitz DJ (1997) Problem in diagnostic imaging. Clin Anat 10(4):279–282PubMedCrossRefGoogle Scholar
  7. Freeny PC (1997) Helical computed tomography of the liver: techniques, applications and pitfalls. Endoscopy 29(6):515–523PubMedCrossRefGoogle Scholar
  8. Herts BR, et al. (1993) Spiral CT of the abdomen: artifacts and potential pitfalls. AJR Am J Roentgenol 161(6): 1185–1190PubMedCrossRefGoogle Scholar
  9. Kanematsu M, et al. (1997) Demonstration of false-negative findings on CT hepatic angiography. Abdom Imaging 22(1):52–54PubMedCrossRefGoogle Scholar
  10. Kanematsu M, et al. (1997) Overestimating the size of hepatic malignancy on helical CT during arterial portography: equilibrium phase CT and pathology. J Comput Assist Tomogr 21(5):713–719PubMedCrossRefGoogle Scholar
  11. Kopka L, et al. (1996) CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation. J Comput Assist Tomogr 20(6):919–923PubMedCrossRefGoogle Scholar
  12. Loh YH, et al. (1997) Diffuse fatty infiltration of the liver: pitfalls in computed tomography diagnosis. Australas Radiol 41(4): 383–386PubMedGoogle Scholar
  13. Mata JM, et al. (1996) Azygos continuation of inferior vena cava associated with an azygos lobe: computed tomography findings. J Thorac Imaging 11(1):89–90PubMedCrossRefGoogle Scholar
  14. Materne R, et al. (1998) Inflammatory pseudotumor of the liver: MRI with mangafodipir trisodium. J Comput Assist Tomogr 22(1):82–84PubMedCrossRefGoogle Scholar
  15. Meyer DR, et al. (1998) Intra-and infrahepatic agenesis of the inferior vena cava with azygos continuation accompanied by duplication of the postrenal segment. Invest Radiol 33(2):113–116PubMedCrossRefGoogle Scholar
  16. Mirowitz SA (1995) MR pitfalls and variants in the extrahepatic abdomen. Magn Reson Imaging Clin N Am 3(1):23–37PubMedGoogle Scholar
  17. Mirowitz SA (1998) Diagnostic pitfalls and artifacts in abdominal MR imaging: a review. Radiology 208(3):577–589PubMedGoogle Scholar
  18. Ogawa T, et al. (1998) A case of inflammatory pseudotumor of the liver causing elevated serum CA19-9 levels. Am J Gastroenterol 93(12):2551–2555PubMedCrossRefGoogle Scholar
  19. Petter LM, et al. (1998) Localized lymphoplasmacellular pancreatitis forming a pancreatic inflammatory pseudotumor. Mayo Clin Proc 73(5):447–450PubMedCrossRefGoogle Scholar
  20. Podbielski FJ, et al. (1997) Giant azvgos vein varix. Ann Thorac Surg 63(4):1167–1169PubMedCrossRefGoogle Scholar
  21. Sakamoto N, et al. (1997) Primary Budd-Chiari syndrome due to complex venous anomalies. Abdom Imaging 22(5):499–501PubMedCrossRefGoogle Scholar
  22. Strouse PJ, et al. (1997) Pitfall: anomalous umbilical vein and absent ductus venosus in association with right congenital diaphragmatic hernia. Pediatr Radiol 27(8):651–653PubMedCrossRefGoogle Scholar
  23. Trigaux JP, et al. (1998) Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT. J Vasc Interv Radiol 9(2):339–345PubMedCrossRefGoogle Scholar
  24. Vilgrain V, et al. (1998) Images in hepatology. Hepatic pseudotumor in Osler-Weber-Rendu disease. J Hepatol 28(2):343Google Scholar
  25. Walsh DW, et al. (1997) Mycotic aneurysm of the aorta: MRI and MRA features. J Magn Reson Imaging 7(2):312–315PubMedCrossRefGoogle Scholar
  26. Wolfhard U, et al. (1997) Bilateral inferior vena cava with azygos continuation but without congenital heart disease complicates routine venous cannulation for cardiopulmonary bypass in an adult. Thorac Cardiovasc Surg 45(1):40–42PubMedCrossRefGoogle Scholar
  27. Zamir D, et al. (1998) Inflammatory pseudotumor of the liver-a rare entitv and a diagnostic challenge. Am J Gastroenterol 93(9):1538–1540PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 1999

Authors and Affiliations

  • W. Jaschke
    • 1
  1. 1.Department of RadiologyUniversity HospitalInnsbruckAustria

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