Hepatocellular carcinoma hidden by multiple infarcted regenerative nodules

Kim, Jin Ah; Ahn, Hye Sung; Park, Haneul; Seo, Yoo Rim; Seo, Ju Hyun; Kim, Chang Wook; Kim, Hee Yeon

doi:10.3904/kjim.2015.028

Cited by 2 publications

(4 citation statements)

References 5 publications

(9 reference statements)

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“…T1-w hyperintensity could be explained by copper or iron deposits [ 45 ] within these nodules or by peri-nodular parenchyma congestion [ 7 ]. Rare cases of T2-w hyperintensity have been related to nodules infarction [ 46 , 47 ]. RN do not present restriction and commonly are iso- or hyperintense on hepatobiliary phase.…”

Section: Hepatic Nodulesmentioning

confidence: 99%

“…Other nation-wide series, however, reported percentages as low as 4% [ 43 ], and a recent systematic review demonstrated a pooled prevalence of 15.4% [ 51 ], suggesting that there are many factors contributing to the development of HCC [ 41 ]. Serum alpha fetoprotein (AFP) levels have a role in the differential diagnosis between HCC and regenerative nodules [ 15 , 16 , 17 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. As radiological features of hepatocellular nodules arising in the context of vascular liver diseases, including BCS are less characteristic, their diagnosis remains challenging, and may require liver biopsy in the end [ 7 ]; however, histologically, HCC nodules in BCS are very-well to well-differentiated hepatocellular proliferations without vascular invasion, leading to a challenging diagnosis with benign proliferations even on pathology [ 15 ].…”

Section: Hepatic Nodulesmentioning

confidence: 99%

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Budd-Chiari Syndrome Imaging Diagnosis: State of the Art and Future Perspectives

2023

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Budd-Chiari syndrome (BCS) is a rare hepatic vascular disorder defined by the presence of partial or complete impairment of hepatic venous drainage in the absence of right heart failure or constrictive pericarditis. Several conditions can lead to BCS, from hypercoagulable states to malignancies. Primary BCS is the most common subtype, and usually bartends hypercoagulability states, while secondary BCS involves tumor invasion or extrinsic compression. A combination of clinical and imaging features leads to the diagnosis of BCS, including (1) direct signs: occlusion or compression of the hepatic veins and/or inferior vena cava, and the presence of venous collaterals; (2) indirect signs: morphological hepatic changes with caudate lobe enlargement; inhomogeneous enhancement, and hypervascular nodules. From a clinicopathological point of view, two forms of BCS can be distinguished: acute and subacute/chronic BCS, although asymptomatic and fulminant forms are also possible. Acute presentations are rare, and symptoms include hepatomegaly, ascites, and hepatic insufficiency. Subacute/chronic forms are the most common presentation, with dysmorphic liver and variable degrees of fibrosis deposition. Patients with chronic BCS can develop benign regenerative nodules (large regenerative nodules or FNH [Focal Nodular Hyperplasia]-like lesions), but are also at a higher risk of hepatocellular carcinoma (HCC). The radiologist role is therefore fundamental in both diagnosis and surveillance of BCS. The aim of this review is to present all clinical and imaging signs that can help to reach the diagnosis of BCS, with their clinical significance, providing tips and tricks for the cross-sectional diagnosis of this condition.

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Section: Hepatic Nodulesmentioning

confidence: 99%

Section: Hepatic Nodulesmentioning

confidence: 99%

Budd-Chiari Syndrome Imaging Diagnosis: State of the Art and Future Perspectives

2023

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“…On enhanced CT scans, infarcted areas are usually detected as hypo‐attenuated spots 3,4 . Hypovascular hepatocellular carcinoma or multiple metastatic tumours are considered differential diagnoses 5 . Liver biopsy is needed for the definitive diagnosis, although it is rarely performed in these cases.…”

Section: Figurementioning

confidence: 99%

“…3,4 Hypovascular hepatocellular carcinoma or multiple metastatic tumours are considered differential diagnoses. 5 Liver biopsy is needed for the definitive diagnosis, although it is rarely performed in these cases. These lesions may mimic malignancy on imaging studies, and careful history taking should be performed to notice the possible ischemic event to the cirrhotic liver.…”

mentioning

confidence: 99%