Hepatocellular Carcinoma with Internal Extensive Coagulation Necrosis: Carefulness of Preoperative Imaging Diagnosis and Comparison with Surgical Specimen
Journal of the Korean Radiological Society
;
: 691-696, 2001.
Artículo
en Coreano
| WPRIM
| ID: wpr-76958
ABSTRACT
PURPOSE:
The aim of this study is to correlate the non-characteristic dual-phase CT imaging findings of hepato-cellular carcinoma with the observed characteristics of surgical specimens. MATERIALS ANDMETHODS:
We studied four cases in which homogeneous low attenuation was observed during the arterial and delayed phases of dynamic CT scanning and in which hepatocellular carcinoma with coagulation necrosis above 95% was pathologically confirmed. We compared the findings of dual phase CT scanning, ultrasonography, angiography and Lipiodol CT scanning with the observed features of surgical specimens.RESULTS:
Nodules were 30-50 (mean, 41) mm in size, and were round in three cases and oval in one. In all four cases, a low density lesion was observed during the arterial and delayed phases of dual-phase CT scanning. Ultrasonography demonstrated internal echo and the presence of a hypoechoic halo, implying that in all cases a capsule was present. At angiography and LiCT, minimal peripheral and central tumor staining or lipiodol up-take was observed. In all surgical specimens a complete capsule was visible, and histologic structures were mainly of the trabecular type, Edmondson grade II or III was recorded, and the mass had undergone extensive coagulation necrosis (above 95%).CONCLUSION:
In cirrhotic liver which is hepatitis B-antigen positive, clear sonographic findings of internal echo and a capsule, rather than a simple cyst, indicate the possibility of hepatocellular carcinoma with extensive coagulation necrosis. This is so even if the arterial and delayed phases of dual-phase CT scanning indicate the presence of a low-density lesion, and in such cases additional work-up is therefore required.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Angiografía
/
Tomografía Computarizada por Rayos X
/
Ultrasonografía
/
Aceite Etiodizado
/
Carcinoma Hepatocelular
/
Diagnóstico
/
Hepatitis
/
Hígado
/
Neoplasias Hepáticas
/
Necrosis
Tipo de estudio:
Estudio diagnóstico
Idioma:
Coreano
Revista:
Journal of the Korean Radiological Society
Año:
2001
Tipo del documento:
Artículo
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