IS Case 293: Riedel's lobe

Benita Tamrazi, MD

Imaging Sciences URMC 2009
Publication Date: 2009-08-05

History

A 58-year-old female presented for right pre-extracorporeal shock wave lithotripsy (ESWL) evaluation.

Findings

A 4 mm calcific density projects at the level of the inferior pole of the right kidney. Air is identified within the stomach, small bowel, and colon in a non-obstructive pattern. Abundant stool is present within the colon. Incidental note is made of a tongue-like projection is noted involving the right lobe of the liver.

Diagnosis

Riedel's lobe

Discussion

Riedel’s lobe of the liver is an anatomical variation which appears as a downward tongue-like projection of the right lobe of the liver. It is not a true hepatic lobe. The incidence varies from 3-30% approximately and is more common in females.

Clinically, it is considered significant based on the fact that it serves as a cause of a palpable abdominal mass. Also, few case reports have documented torsion of Riedel’s lobe and therefore knowledge of its existence can be clinically significant in patients with abdominal pain and palpable masses. In addition, the inclusion of the entire elongated lobe should be considered in imaging procedures where there is a clinical suspicion of metastasis because the anatomic variant may be involved in disease.

References

Kudo M. Riedel’s lobe of the liver and its clinical implication. Intern Med. 2000 Feb;39(2):87-8. PMID: 10732821 [PubMed]