Liver mass evaluation: Difference between revisions
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==Liver Mass Evaluation== | ==Liver Mass Evaluation== | ||
*The initial evaluation of liver mass, should include: detailed medical history, physical examination, biochemical and blood tests (AFP levels, serology for hepatitis), and imaging studies. | *The initial evaluation of liver mass, should include: detailed medical history, physical examination, biochemical and blood tests (AFP levels, serology for hepatitis), and imaging studies. | ||
*The algorithm below summarizes the | *The algorithm below summarizes the evaluation of solitary liver mass with history of cirrhosis or chronic HBV infection:<ref name="pmid22541698">{{cite journal |vauthors=Bonder A, Afdhal N |title=Evaluation of liver lesions |journal=Clin Liver Dis |volume=16 |issue=2 |pages=271–83 |year=2012 |pmid=22541698 |doi=10.1016/j.cld.2012.03.001 |url=}}</ref> | ||
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Revision as of 21:44, 29 January 2018
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Liver Mass Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Liver mass evaluation On the Web |
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American Roentgen Ray Society Images of Liver mass evaluation |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
A hallmark feature in the evaluation of liver mass is the malignancy assessment. The evaluation approach of liver mass will mainly depend in the initial morphological evaluation of the mass (size, margins, contours, imaging pattern, and growth). Other characteristics, such as: location, clinical features, and distribution may be helpful for the therapeutical management, surveillance, and follow-up of liver mass. Lung mass can be divided into 2 categories: benign liver mass and malignant liver mass. Based upon these categories, complementary diagnostic studies and management, include: PET/CT scan, MRI, non-surgical biopsy, and surgical resection.
Liver Mass Evaluation
- The initial evaluation of liver mass, should include: detailed medical history, physical examination, biochemical and blood tests (AFP levels, serology for hepatitis), and imaging studies.
- The algorithm below summarizes the evaluation of solitary liver mass with history of cirrhosis or chronic HBV infection:[1]
| Solitary liver mass with a history of cirrhosis or HBV infection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| <1cm | >1cm | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Contrast MRI | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Atypical for HCC | Typical for HCC | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ultrasound in 3 months | Specific treatment | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Stable | Abnormal growth or change in character | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Repeat ultrasound in 3-5 months | MDCT(dynaminc contrast induced MRI | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Abnormal growth or change in character | Atypical for HCC | Typical for HCC | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Follow up with MDCT(dynaminc contrast induced MRI | CA19-9 | Specific treatment | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Normal | Elevated | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Biopsy for specific diagnosis | H/O of cholangitis or cholistasis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treat cholingitis/cholestasis and check CEA19-9 levels again | Resection of lesion | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Elevated | Normal | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Resection of lesion | Biopsy of lesion | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.