Case 3:   Abscess (pyogenic)

Diagnostic Category:

Clinical Presentation:

55 year old Cambodian woman with septic picture due to acute appendicitis.

CT: Cluster sign and adjacent loculation

Imaging Findings:

CT shows pyogenic liver abscess in segment 7/8 positive for Streptococcus milleri. Evolution of a pyogenic abscess.

First row: Acute stage ("cluster sign") of abscess without capsule (see also last image).

Second row: Same abscess - subacute stage, more superior unilocular portion with developing capsule, and intraoperatively placed drain in loculation. Note that in hepatic steatosis the various contrast phases all demonstrate similar ring enhancement and a perifocal edema is not appreciated due to the hypodense background.