Year 2021 / Volume 113 / Number 11
Letter
“Hot quadrate lobe spot” sign in chronic superior vena cava obstruction

805-806

DOI: 10.17235/reed.2021.8154/2021

Cristina Gómez Varela, Iria Couto Rodríguez,

Abstract
We report the case of a 65-year-old male patient who consulted for swelling of the face and neck after having a pacemaker implantated. Contrast-enhanced chest computerized tomography (CT) confirmed a thrombus within the superior vena cava (SVC). Thus, therapy with oral anticoagulants was initiated, which obtained a good clinical response and resolution of symptoms. A follow-up contrast-enhanced CT scan of the chest and abdomen showed a focal, well-delimited, hyperdense area in the IV hepatic segment during the arterial and portal venous phases, which was associated with persistence of the SVC repletion defect and the presence of multiple superficial venous collaterals in the right anterolateral thoraco-abdominal wall. The hepatic image corresponded to the sign of the "hot spot" or "hot quadrate lobe", a hepatic pseudolesion that should not be confused with other focal hypervascular lesions.
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References
1. Dickson AM. The focal hepatic hot spot sign. Radiology 2005;237(2):647-8.
2. Kalisz K, Enzerra M, Ansari-Gilani K. Cardiovascular findings on cross-sectional imaging: spectrum of incidental and critical findings and clinical relevance for the abdominal radiologist. Abdominal Radiology 2019;44:1161-80.
3. Kapur S, Paik E, Rezaei A, et al. Where There Is Blood, There Is a Way: Unusual Collateral Vessels in Superior and Inferior Vena Cava Obstruction. RadioGraphics 2010;30(1):67-78.
4. Sonavane SK, Milner DM, Singh SP, et al. Comprehensive Imaging Review of the Superior Vena Cava. RadioGraphics 2015;35:1873-92.
5. Virmani V, Anupam L, Chirag KA, et al. The CT Quadrate lobe hot spot sign. Annals of Hepatology 2010;9(3):296-8.
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Gómez Varela C, Couto Rodríguez I. “Hot quadrate lobe spot” sign in chronic superior vena cava obstruction. 8154/2021


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Publication history

Received: 13/06/2021

Accepted: 13/07/2021

Online First: 28/07/2021

Published: 05/11/2021

Article revision time: 27 days

Article Online First time: 45 days

Article editing time: 145 days


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