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Japanese Journal of Clinical Oncology 30:440-445 (2000)
© 2000 Foundation for Promotion of Cancer Research

Highly Enhanced Hepatic Masses Seen on CT During Arterial Portography: Early Hepatocellular Carcinoma and Adenomatous Hyperplasia

Hiroaki Onaya1,2, Yuji Itai2, Mitsuo Satake1, Tianyou Luo2, Yukihisa Saida2, Masatora Haruno1,+, Takahiro Hasebe3 and Noriyuki Moriyama4

1Diagnostic Radiology Division, National Cancer Center Hospital East, Kashiwa, Chiba, 2Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, 3Pathology Division, National Cancer Center Hospital Research Institute, Kashiwa, Chiba and 4Diagnostic Radiology Division, National Cancer Center Hospital, Tokyo, Japan

Background: To describe computed tomographic (CT) features of highly enhanced hepatic masses as seen on CT during arterial portography (CTAP) and to survey the varieties of hepatic lesions associated with such findings.

Methods: CTAP files for 400 patients were reviewed, on the basis of which six patients with highly enhanced hepatic masses were selected. These six patients also subsequently underwent CT during hepatic arteriography (CTHA) on the same day. All the patients had chronic liver damage, which was cirrhotic in five cases. Five had a current diagnosis and one had a history of hepatocellular carcinoma (HCC).

Results: Solitary highly enhanced masses were observed on CTAP in three patients, three masses were seen in one patient and multiple (10–12) masses in the other two patients. All the CTAP-enhanced masses except one were round in shape and homogeneous in attenuation. The size of the mass ranged from 6 to 25 mm in diameter. In all except two nodules in one patient, the masses were hypoattenuated on CTHA. On histopathological examination of five nodules in three patients, the nodular lesions were consistent with so-called early HCC (well-differentiated HCC of Edmondson I) in four nodules and adenomatous hyperplasia in the other nodule.

Conclusions: Highly enhanced hepatic masses relative to the surrounding liver parenchyma have been sporadically noted on CTAP, especially in patients with liver cirrhosis. When present, such nodules are typically hypoattenuated on CTHA and histological features are consistent with early HCC and adenomatous hyperplasia.

+ For reprints and all correspondence: Hiroaki Onaya, Diagnostic Radiology Division, National Cancer Center Hospital East, 5–1 Kashiwanoha 6-chome, Kashiwa, Chiba 277–8577, Japan. E-mail: honaya@east.ncc.go.jp


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