Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma?

Diagn Interv Radiol. 2014 May-Jun;20(3):222-8. doi: 10.5152/dir.2014.13184.

Abstract

Detection and characterization of focal lesions in the cirrhotic liver may pose a diagnostic dilemma. Several benign and malignant lesions may be found in a cirrhotic liver along with hepatocellular carcinoma (HCC), and may exhibit typical or atypical imaging features. In this pictorial essay, we illustrate computed tomography and magnetic resonance imaging findings of lesions such as simple bile duct cysts, hemangioma, focal nodular hyperplasia-like nodules, peribiliary cysts, intrahepatic cholangiocarcinoma, lymphoma, and metastases, all of which occur in cirrhotic livers with varying prevalences. Pseudolesions, such as perfusion anomalies, focal confluent fibrosis, and segmental hyperplasia, will also be discussed. Imaging characterization of non-HCC lesions in cirrhosis is important in formulating an accurate diagnosis and triaging the patient towards the most appropriate management.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Diseases / diagnosis
  • Bile Duct Diseases / pathology
  • Bile Duct Neoplasms / diagnosis
  • Bile Duct Neoplasms / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Carcinoma, Hepatocellular / pathology
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / pathology
  • Cysts / pathology
  • Female
  • Focal Nodular Hyperplasia / diagnosis
  • Focal Nodular Hyperplasia / pathology
  • Hemangioma / diagnosis
  • Hemangioma / pathology
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / pathology
  • Liver Diseases / diagnosis
  • Liver Diseases / pathology*
  • Liver Neoplasms / complications
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / pathology
  • Lymphoma / diagnosis
  • Lymphoma / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prevalence
  • Tomography, X-Ray Computed*