Purpose or Case Report: The purpose of this educational exhibit is to demonstrate the imaging characteristics of several conditions that cause multifocal liver lesions in children that are immunocompromised, have a history of malignancy, or being treated for a malignancy using a radiological multi-modality method.
Methods & Materials: Multiple hepatic lesions are not uncommon findings in children that are immunocompromised, have a history of malignancy, or being treated for a malignancy. It is a challenge for the radiologist to differentiate between several causes such as metastases, fungal/bacterial infections, lymphoproliferative disease, multiple focal nodular hyperplasia, hepatic hemangiomas, and extra medullary hematopoietic marrow.

Many of these conditions have very similar findings on imaging, requiring percutaneous needle or open biopsy for an accurate diagnosis. However, it is possible sometimes to make the diagnosis, or at least narrow it down, depending on imaging characteristics and the clinical presentation.

We are going to present several cases of patients with multiple hepatic lesions as seen on ultrasound, CT, MRI, and Nuclear Medicine (PET CT, HIDA scan). The radiologic appearances of lesions in each modality will be discussed. Imaging findings were correlated with clinical, laboratory, and pathologic information.
Results: In this exhibit, we will present cases of hepatic metastases (neuroblastoma, Wilm's tumor, etc.), fungal/bacterial microabscesses, lymphoproliferative disease, multiple focal nodular hyperplasia, hepatic hemangiomas, and extra medullary hematopoietic marrow. All of these cases were in children that have previous treated malignancy, being treated for malignancy, recently diagnosed with malignancy but not treated yet, or immunocompromised. All of these patients have serial imaging using different modalities.
Conclusions: It is essential for radiologists to be able to recognize the imaging characteristics of multifocal liver lesions in children that are immunocompromised, have a history of malignancy, or being treated for a malignancy. The viewer will be familiar with these imaging characteristics and how to approach the imaging studies and what to look for.