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Problematic lesions in cirrhotic liver mimicking hepatocellular carcinoma

Authors
 Myeong-Jin Kim  ;  Sunyoung Lee  ;  Chansik An 
Citation
 European Radiology, Vol.29(9) : 5101-5110, 2019 
Journal Title
 European Radiology 
ISSN
 0938-7994 
Issue Date
2019
Keywords
Computed tomography, X-ray ; Diagnosis, differential ; Liver cirrhosis ; Liver neoplasms ; Magnetic resonance imaging
Abstract
Hepatocellular carcinoma (HCC) is a unique malignancy that can be diagnosed and treated based on non-invasive imaging criteria without histological confirmation in cirrhotic patients, which opens the possibility, although rare, of false-positive diagnosis of the tumor. This brief review illustrates benign and non-HCC malignant lesions arising in cirrhotic liver that could have been erroneously diagnosed as HCC based on imaging criteria: focal nodular hyperplasia-like nodules, serum amyloid A-positive nodules, dysplastic nodules, spontaneously regressing lesions, combined hepatocellular-cholangiocarcinoma, cholangiocarcinoma, sarcomatoid carcinoma, lymphoepithelioma-like carcinoma, hepatoblastoma, and metastatic adenocarcinoma. To determine the potential differences in clinical courses and post-treatment outcome of HCC diagnosed by imaging alone and those histologically, we suggest the terms HCCi and HCCp to distinguish between lesions that are diagnosed as HCC based on imaging alone from those diagnosed based on pathological examination, respectively.Key Points • Benign lesions, such as focal nodular hyperplasia-like nodules, serum amyloid A-positive nodules, dysplastic nodules, and spontaneously regressing lesions, may show imaging findings that mislead to the diagnosis of HCC. • Non-hepatocellular malignant lesions, such as sarcomatoid carcinoma, lymphoepithelioma-like carcinoma, hepatoblastoma, and metastatic adenocarcinomas, can be erroneously diagnosed as HCC based on imaging findings alone, even in cirrhotic liver.
Full Text
https://link.springer.com/article/10.1007%2Fs00330-019-06030-0
DOI
10.1007/s00330-019-06030-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Lee, Sunyoung(이선영) ORCID logo https://orcid.org/0000-0002-6893-3136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171275
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