The authors describe a case of nodular regenerative hyperplasia of the liver and its findings on liver SPECT with Tc-99m radiocolloid and Tc-99m neoglycoalbumin. A 22-year-old woman with systemic lupus erythematosus was hospitalized for intractable thrombocytopenia. A diagnostic work-up including CT revealed multiple liver nodules and portal hypertension with splenomegaly, suggesting hypersplenism as a cause of the thrombocytopenia. Liver SPECT with Kupffer cell-oriented Tc-99m stannous colloid and hepatocyte-oriented Tc-99m neoglycoalbumin showed increased uptake in the liver nodules, indicating the presence of Kupffer cells and hepatocytes. The patient underwent splenectomy and wedge liver biopsy. Pathologic analysis of the liver specimen revealed many hyperplastic nodules and sinusoidal congestion without cirrhosis. Based on these histopathologic features, the diagnosis of nodular regenerative hyperplasia of the liver was made.
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