Hypervascular Hyperplastic Nodules Appearing in Chronic Alcoholic Liver Disease: Benign Intrahepatic Nodules Mimicking Hepatocellular Carcinoma

Park, Won Kyu; Chang, Jay Chun; Kim, Jae Woon; Cho, Jaeho; Lee, Jae Kyo; Lee, Heon Zu; Yun, Sukyoung; Lee, Dong Shik; Choi, Joon Hyuk; Hwang, Tae Yoon; Eun, Jong Ryul

doi:10.3348/jkrs.2006.54.2.113

Cited by 4 publications

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“…Eight HHNs in the liver were recently reported in seven patients with chronic alcoholic liver disease or cirrhosis. 4 In six of the eight cases with follow-up CT, five nodules showed a decrease in size within 36 months, and one disappeared within eight months.…”

Section: Introductionmentioning

confidence: 83%

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases

Joo

Park

Rhee

et al. 2015

Korean J Gastroenterol

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Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis. (Korean J Gastroenterol 2015;65:321-325)

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Section: Introductionmentioning

confidence: 83%

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases

Joo

Park

Rhee

et al. 2015

Korean J Gastroenterol

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“…Several studies have evaluated the imaging findings of HHN in patients with ALC. Some studies using CT reported that it was difficult to exactly differentiate HHN from HCC; another study using MRI included only small number of HHNs. A recent study investigated the imaging features for distinguishing HHN from HCC on gadoxetic acid‐enhanced MRI (Gd‐EOB‐MRI), but that study compared imaging findings between HHN and HCC with paradoxical uptake on the hepatobiliary phase (HBP) image, and enrolled patients with viral LC (65.9%) .…”

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confidence: 99%

Value of gadoxetic acid‐enhanced MRI and diffusion‐weighted imaging in the differentiation of hypervascular hyperplastic nodule from small (<3 cm) hypervascular hepatocellular carcinoma in patients with alcoholic liver cirrhosis: A retrospective case–control study

Kim

Song

Choi

et al. 2019

Magnetic Resonance Imaging

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Background: Hypervascular hyperplastic nodules (HHNs) occasionally develop in patients with alcoholic liver cirrhosis (ALC) and show arterial enhancement, thus mimicking hepatocellular carcinoma (HCC). Importantly, HHN as a benign lesion should be distinguished from HCC. Purpose: To evaluate the value of gadoxetic acid-enhanced MRI (Gd-EOB-MRI) and diffusion-weighted imaging (DWI) in distinguishing HHN from small (<3 cm) hypervascular HCC (hHCC) in patients with ALC. Study Type: Retrospective case-control study. Field Strength/Sequence: 3.0T/in-and out-of-phase, T 1 -weighted, T 2 -weighted, diffusion-weighted, apparent diffusion coefficient, and dynamic gadoxetic acid-enhanced images. Population: Among 560 patients with ALC who underwent Gd-EOB-MRI and DWI, 12 patients with 28 HHNs and 22 patients with 29 hHCCs smaller than 3 cm were included. Assessment: The following MRI features were evaluated by three independent radiologists: signal intensity (SI) on T 1 -weighted, T 2 -weighted, diffusion-weighted, and hepatobiliary phase (HBP) images; shape, homogeneity, and margin on HBP; diffusion restriction; intralesional fat; necrosis; hemorrhage; washout on portal venous phase (PVP) and/or transitional phase (TP); and capsular enhancement. Quantitative analysis was also conducted. Statistical Tests: Univariate and multivariate analyses were performed to determine the significant MRI findings, and their diagnostic performance for the prediction of HHN was analyzed. Results: Lesion size of ≤16 mm (odds ratio [OR], 24.41; P = 0.007), low-to-iso SI on DWI (OR, 26.92; P = 0.007), and absence of washout on PVP and/or TP (OR, 31.84; P = 0.009) were significant independent factors for predicting HHN. When all three criteria were satisfied, the specificity was 100%. Compared with hHCCs, HHNs showed significantly smaller View this article online at wileyonlinelibrary.com.

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A case of hypervascular hyperplastic nodules mimicking hepatocellular carcinoma in alcoholic liver cirrhosis

et al. 2009

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Benign hypervascular hyperplastic nodules (HHN) in liver cirrhosis are very rare. It is important to distinguish between regenerative nodules (hyperplastic nodules) and tumorous nodules (dysplastic or neoplastic nodules) in hepatocellular nodular lesions. The differential diagnosis between HHN and hepatocellular carcinoma on the basis of radiologic imaging is often difficult, and is clinically important when determining the therapeutic plan. Therefore, histological confirmation by needle biopsy sampling of the liver is necessary for a correct diagnosis of HHN. We report herein a case of benign HHN mimicking hepatocellular carcinoma in a 32-year-old male alcoholic liver cirrhosis patient without viral hepatitis infection.

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Hypervascular Hyperplastic Nodules Appearing in Chronic Alcoholic Liver Disease: Benign Intrahepatic Nodules Mimicking Hepatocellular Carcinoma

Cited by 4 publications

References 0 publications

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases

Value of gadoxetic acid‐enhanced MRI and diffusion‐weighted imaging in the differentiation of hypervascular hyperplastic nodule from small (<3 cm) hypervascular hepatocellular carcinoma in patients with alcoholic liver cirrhosis: A retrospective case–control study

A case of hypervascular hyperplastic nodules mimicking hepatocellular carcinoma in alcoholic liver cirrhosis

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