Hepatomegalie

Hepatomegaly refers to an increase in size or enlargement of the liver.

Pathology

Etiology

Hepatomegaly can result from a vast range of pathology including, but not limited to, the following:

• malignancy/cellular infiltrate
  • multiple metastases
  • lymphoma(s)
  • leukemia(s)
  • hepatocellular carcinoma
  • extramedullary hematopoiesis
  • systemic mastocytosis
  • angiosarcoma 
• acquired hepatic conditions
  • hepatic steatosis
  • cirrhosis - early
  • secondary hemochromatosis
  • hepatic amyloidosis
  • hepatic veno-occlusive disease
  • sarcoidosis
  • infectious mononucleosis
  • acute hepatitis
  • primary biliary cholangitis
  • hepatic tuberculosis 
  • histoplasmosis 
• acquired non-hepatic conditions
  • right heart failure
• congenital anomalies
  • biochemical
    • glycogen storage disease
    • primary hemochromatosis
    • Gaucher disease
    • certain mucopolysaccharidoses - e.g. Hunter syndrome
    • Niemann-Pick disease
    • Wilson disease
    • chronic granulomatous disease of childhood
    • Weber-Christian disease
    • galactosemia
  • anatomical
    • biliary atresia
• syndromes
  • Zellweger syndrome

Radiographic features

Assessment of liver size is commonly made on ultrasound or CT, although gross hepatomegaly may be apparent on abdominal radiograph.

For the adult liver:

• midclavicular line averages 10-12.5 cm in craniocaudal length
  • a liver that is longer than 15.5-16 cm in the midclavicular line (MCL) is considered enlarged
• average transverse diameter is 20-23 cm at the level of the upper pole of the right kidney

In practice, however, assessment is often subjective.

Features that support hepatomegaly include :

• extension of the right lobe inferior to the lower pole of the right kidney
• rounding of the hepatic inferior border

Differential diagnosis

• Riedel lobe (normal variant)

See also

• hepatosplenomegaly

Siehe auch:

• Morbus Gaucher
• chronic lymphocytic leukaemia
• Glykogenspeicherkrankheit
• connatale Zytomegalie
• Venenverschlusskrankheit der Leber

und weiter:

• Wolman disease
• Rai staging system for chronic lymphoid leukaemia
• primary familial xanthomatosis