Hepatic perivascular lymphedema: CT appearance.

The CT appearance of dilated hepatic lymphatics in liver transplant recipients has been described recently. We have observed similar findings of presumed hepatic lymphatic dilatation and perivascular lymphedema in 20 patients seen over an 8-month period, none of whom had received a liver transplant. Review of these patients' records showed that 18 (90%) of 20 had underlying disease processes that could have caused dilated lymphatics as a result of either increased lymph flow or lymphatic obstruction. We have grouped these processes into three etiologic categories: (1) posttraumatic hepatic lymphatic obstruction, (2) obstruction caused by malignant lymphadenopathy, and (3) congestive hepatomegaly caused by cardiac decompensation. The appearance of hepatic lymphatic dilatation and surrounding lymphedema needs to be recognized so that lymphatic dilatation is not mistaken for dilated intrahepatic bile ducts.