False positive liver scans caused by disease processes in adjacent organs and structures

Abstract

As a result of its great pliability, the liver can change its shape and form when impinged upon by disease processes in neighbouring organs and structures. The resultant hepatic scan is quite confusing, since the picture portrayed is frequently indistinguishable from that of intrinsic space-occupying disease of the liver. Enlarged gall-bladders, kidney cysts and tumours, pancreatic lesions, dilated bile ducts and subdiaphragmatic fluid are examples of extrahepatic disease processes that can simulate intrahepatic defects. It is quite essential that the physician interpreting hepatic scans has an appreciation that such a situation can exist. In this manner, one may hopefully reduce the incidence of his “false positive” interpretations. When doubt exists on the hepatic scan, a careful consideration of the clinical and laboratory findings, as well as the employment of complementary radiographic techniques such as selective angiography, can help elucidate the problem.