Hepatic Papillary Process - An Anatomic Variant of Liver

Hepatic Papillary process is an anatomic variant of liver. When large can simulate mass lesion in pancreatic head region or periportal lymphnode on imaging however liver tissue characteristics and continuity of the process with the caudate lobe facilitate the differentiation between extrahepatic portocaval mass and papillary process. (1) CT is the modility of choice for the right diagnosis of liver anatomical variants. Case Report A 48 years female was admitted in the medicine department of our hospital with complaints of fever and pain lower abdomen associated with nausea and burning micturition. She was known hypertensive as well as diabetic for last 5 years and had undergone cholecystectomy for gall bladder calculi. On clinical examination she was febrile and pale and had hepatosplenomegaly. Her BP was 136/96 mm of Hg. On investigating her HB was 5.3 gm%, RFT's were normal, SGOT and SGPT were also normal, however alkaline phosphatase and Gamma-Glutamyl transferase were raised. Her serum Alphafetoprotein was 6.881 ngm/ml and blood sugar (F) was 225 mg/ml. On ultrasonography, liver was enlarged, 17 cm in size Abstract Hepatic Papillary process is an anatomic variant of liver. When large can simulate mass lesion in pancreatic head region or periportal lymphnode on imaging however liver tissue characteristics and continuity of the process with the caudate lobe facilitate the differentiation between extrahepatic portocaval mass and papillary process. CT is the modility of choice for the right diagnosis of liver anatomical variants.