Hepatocellular carcinoma differential diagnosis: Difference between revisions
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Hepatocellular [[carcinoma]] must be differentiated from other diseases that cause [[abdominal pain]], [[jaundice]], and [[weight loss]], such as [[hepatitis B]], [[hepatitis C]], liver cirrhosis, and [[pancreatitis]]. | Hepatocellular [[carcinoma]] must be differentiated from other diseases that cause [[abdominal pain]], [[jaundice]], and [[weight loss]], such as [[hepatitis B]], [[hepatitis C]], liver cirrhosis, and [[pancreatitis]]. | ||
==Differentiating Hepatocellular Carcinoma from other Diseases== | ==Differentiating Hepatocellular Carcinoma from other Diseases== | ||
Hepatocellular carcinoma must be differentiated from the following diseases: | Hepatocellular carcinoma must be differentiated from the following diseases:<ref name="pmid26770920">{{cite journal |vauthors=Kim TK, Lee E, Jang HJ |title=Imaging findings of mimickers of hepatocellular carcinoma |journal=Clin Mol Hepatol |volume=21 |issue=4 |pages=326–43 |year=2015 |pmid=26770920 |pmc=4712159 |doi=10.3350/cmh.2015.21.4.326 |url=}}</ref><ref name="Ferrell2000">{{cite journal|last1=Ferrell|first1=Linda|title=Liver Pathology: Cirrhosis, Hepatitis and Primary Liver Tumors. Update and Diagnostic Problems|journal=Modern Pathology|volume=13|issue=6|year=2000|pages=679–704|issn=0893-3952|doi=10.1038/modpathol.3880119}}</ref> | ||
*[[ | *Angiomyolipoma | ||
* | *Adenoma | ||
* | *Borderline (high-grade dysplastic) nodule | ||
*Cholangiocarcinoma | |||
*Confluent fibrosis | |||
*Focal nodular hyperplasia | |||
*Focal fat sparing and deposit on liver | |||
*[[Gallbladder cancer]] | |||
*Hereditary hemorrhagic telangiectasia | |||
*Inflammatory pseudotumors | |||
*[[Hemangioma|Liver hemangioma]] | *[[Hemangioma|Liver hemangioma]] | ||
* | *Hepatoblastoma in children | ||
** | *Inflammatory lesions | ||
** | *Mesenchymal hamartoma in children | ||
** | *Multiacinar regenerative nodule | ||
*[[ | *Macroregenerative nodule (low-grade dysplastic nodule) | ||
* | *Nontumorous arterioportal shunts | ||
*Pseudomass in chronic portal vein thrombosis | |||
*Pyogenic liver abscesses | |||
*[[Pancreatic cancer]] | |||
*[[Stomach cancer]] | |||
'''Abbreviations:''' | '''Abbreviations:''' | ||
Revision as of 22:45, 18 January 2018
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Hepatocellular carcinoma Microchapters |
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Hepatocellular carcinoma differential diagnosis On the Web |
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American Roentgen Ray Society Images of Hepatocellular carcinoma differential diagnosis |
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Risk calculators and risk factors for Hepatocellular carcinoma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2] Mohamad Alkateb, MBBCh [3]
Overview
Hepatocellular carcinoma must be differentiated from other diseases that cause abdominal pain, jaundice, and weight loss, such as hepatitis B, hepatitis C, liver cirrhosis, and pancreatitis.
Differentiating Hepatocellular Carcinoma from other Diseases
Hepatocellular carcinoma must be differentiated from the following diseases:[1][2]
- Angiomyolipoma
- Adenoma
- Borderline (high-grade dysplastic) nodule
- Cholangiocarcinoma
- Confluent fibrosis
- Focal nodular hyperplasia
- Focal fat sparing and deposit on liver
- Gallbladder cancer
- Hereditary hemorrhagic telangiectasia
- Inflammatory pseudotumors
- Liver hemangioma
- Hepatoblastoma in children
- Inflammatory lesions
- Mesenchymal hamartoma in children
- Multiacinar regenerative nodule
- Macroregenerative nodule (low-grade dysplastic nodule)
- Nontumorous arterioportal shunts
- Pseudomass in chronic portal vein thrombosis
- Pyogenic liver abscesses
- Pancreatic cancer
- Stomach cancer
Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram
| Disease | Clinical manifestations | Diagnosis | Comments | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | |||||||||||||||
| Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | ||
| Hepatocellular carcinoma/Metastasis | RUQ | + | − | − | + | − | − | + | − | − | − | − |
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Other symptoms: |
| Chronic pancreatitis | Epigastric | − | − | ± | ± | − | + | + | − | − | − | − | N | CT scan
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| Pancreatic carcinoma | Epigastric | − | − | + | + | − | + | + | − | − | − | − | N |
Skin manifestations may include: | ||
| Inflammatory bowel disease | Diffuse | ± | − | − | ± | − | + | + | + | − | − | − | Normal or hyperactive |
Extra intestinal findings: | ||
| Disease | Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | Comments |
| Whipple's disease | Diffuse | ± | − | − | ± | − | + | + | − | ± | − | − | N | Endoscopy is used to confirm diagnosis.
Images used to find complications |
Extra intestinal findings: | |
| Viral hepatitis | RUQ | + | − | + | + | − | Positive in Hep A and E | + | − | Positive in fulminant hepatitis | Positive in acute | + | N |
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| Liver abscess | RUQ | + | + | + | + | − | ± | + | − | + | + | ± | Normal or hypoactive |
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| Cirrhosis | RUQ | − | − | − | + | − | − | + | + | + | − | − | N |
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US
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References
- ↑ Kim TK, Lee E, Jang HJ (2015). "Imaging findings of mimickers of hepatocellular carcinoma". Clin Mol Hepatol. 21 (4): 326–43. doi:10.3350/cmh.2015.21.4.326. PMC 4712159. PMID 26770920.
- ↑ Ferrell, Linda (2000). "Liver Pathology: Cirrhosis, Hepatitis and Primary Liver Tumors. Update and Diagnostic Problems". Modern Pathology. 13 (6): 679–704. doi:10.1038/modpathol.3880119. ISSN 0893-3952.