Zahn infarct of the liver resulting from occlusive phlebitis in portal vein radicles.

Abstract

A 56-yr-old man had a solitary nodular mass in the right hepatic lobe. The nodule was clinically diagnosed as hepatocellular carcinoma, and a right hepatic lobectomy was performed. The nodule had a previously undescribed histological appearance, and was finally diagnosed as a Zahn infarct with the additional feature of fibrosis. We think that the mass was produced by occlusive phlebitis in a medium-size portal vein radicle and its smaller radicles. This is the case of a very unique Zahn infarct in two respects: 1) the histological appearance (fibrosis), and 2) the fact that it was due to occlusive phlebitis in portal vein radicles. The data obtained here indicate that a special type of Zahn infarct, as represented by this case, may present with clinical information (nodular mass and neovascularity) suggestive of hepatocellular carcinoma.