Pleural and pulmonary staining at inferior phrenic arteriography mimickinga tumor staining of hepatocellular carcinoma

Purpose: To describe the findings of pleural and pulmonary staining of the inferior phrenic artery, which can be confused with tumor staining during t ransarterial chemoembolization (TACE) of hepatoma. Methods: Fifteen patients who showed pleural and pulmonary staining without relationship to hepatic masses at inferior phrenic arteriography were enro lled. The staining was noted at initial TACE (n = 8), at successive TACE (n 5), and after hepatic surgery (n = 2). The angiographic pattern, the prese nce of pleural change on computed tomography (CT), and clinical history wer e evaluated. Results: Draining pulmonary veins were seen in all cases. The lower margin of the staining corresponded to the lower margin of the pleura in 10 patien ts. CT showed pleural and/or pulmonary abnormalities in all cases. After em bolization of the inferior phrenic artery, the accumulation of iodized oil in the lung was noted. Conclusion: Understanding the CT and angiographic findings of pleural and p ulmonary staining during TACE may help differentiate benign staining from t umor staining.