Diffusion-weighted imaging might be useful for reactive lymphoid hyperplasia diagnosis of the liver: A case report

BACKGROUND Reactive lymphoid hyperplasia(RLH)of the liver is a rare liver lesion.It is considered difficult to differentiate radiologically from hepatocellular carcinoma,metastatic liver tumor and other pathologies.CASE SUMMARY A 54-year-old woman presented to our hospital with RLH of the liver.The patient had a diagnosis of metastatic carcinoma of the liver from an unknown origin and subsequently underwent partial hepatectomy.However,histopathological analysis revealed RLH.The lesion showed perinodular enhancement in the arterial phase on contrast-enhanced computed tomography and magnetic resonance imaging.On diffusion-weighted imaging(DWI),we encountered linear hyperintensity along the portal tract consecutive to the liver lesion,which is a new characteristic radiologic finding.This finding corresponded to the lymphoid cell infiltration of the portal tract.Furthermore,there was strongly restricted diffusion on the apparent diffusion coefficient map.We used these characteristic radiologic findings to diagnose the lesion as a lymphoproliferative disease.CONCLUSION The linear hyperintensity consecutive to the liver lesion on DWI provided additional valuable diagnostic information.

Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery:Two case reports

BACKGROUND The ascending pharyngeal artery(APhA)comprises the pharyngeal trunk(PT)and neuromeningeal trunk.The PT feeds the nasopharynx and adjacent tissue,which potentially connects with the sphenopalatine artery(SPA),branched from the internal maxillary artery(IMA).Due to its location deep inside the body,the PT is rarely injured by trauma.Here,we present two cases that underwent transcatheter arterial embolization(TAE)of the PT of the APhA due to trauma and iatrogenic procedure.CASE SUMMARY Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up.The nasal airway was inserted as glossoptosis occurred during sedation.Bleeding from the nasopharynx was observed during the endoscopic procedure.As the bleeding continued,the patient was referred to our hospital for further treatment.Contrast-enhanced computed tomography(CT)demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa.TAE was performed and the extravasation disappeared after embolization.Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital.Contrastenhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx.Angiography demonstrated an irregular third portion of the IMA.As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA,additional TAE to the artery was performed.The bleeding stopped after the procedure.CONCLUSION Radiologists should be aware that the PT of the APhA can be a bleeding source,which has a potential connection with the SPA.