Ir. Wanless et al., LIPIODOL ACCUMULATION IN HEPATIC HEMANGIOMA - DETECTION WITH OSMIUM POSTFIXATION, The American journal of surgical pathology, 20(4), 1996, pp. 480-482
Lipiodol has been used to increase the detectability of small primary
neoplasms in the liver. We report a patient who was found to have lipi
odol deposits in the liver one month after intra-arterial injection. T
he region was resected, under ultrasound control, because of the impre
ssion that the lesion was malignant. The specimen contained two small
hemangiomas as well as many small dysplastic nodules (adenomatous hype
rplasia) in a noncirrhotic parenchyma. To locate the lipiodol deposit
in this case, the tissue was radiographed, postfixed in osmium tetroxi
de, and embedded in paraffin. Black osmium-stained deposits were found
within the cavities of the hemangiomas but not in the dysplastic nodu
les. Most of the deposits were extracellular multivesiculated bodies w
ith a small focus of lipid droplets engulfed by multinucleated foreign
-body type giant cells. This report reinforces that hepatic lipiodol r
etention is not specific for hepatocellular carcinoma. We present, for
the first time, the histologic appearance of lipiodol accumulation in
an hemangioma. The value of osmium tetroxide postfixation for the det
ection of lipiodol is also demonstrated.