Hepatocellular adenoma: Difference between revisions
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===Computed Tomography=== | ===Computed Tomography=== | ||
* Fat or hemorrhage can easily be identified on unenhanced images, and delayed-phase images demonstrate the tendency for fibrotic components to enhance and retain contrast material. * Because adenomas consist almost entirely of uniform hepatocytes and a variable number of Kupffer cells, most adenomas are nearly isoattenuating relative to normal liver on unenhanced, portal venous–phase, and delayed-phase images. * In patients with fatty liver, adenomas are hyperattenuating at all phases of contrast enhancement and on unenhanced images as well. * Small hepatocellular adenomas enhance rapidly and are hyperattenuating relative to the liver. * Excluding lesions with acute or old tumor hemorrhage and fat deposition, hepatocellular adenoma demonstrated homogeneous or nearly homogeneous enhancement in approx 80% of cases. ** The enhancement usually does not persist in adenomas because of arteriovenous shunting. * Larger hepatocellular adenomas may be more heterogeneous than smaller lesions, and their CT appearance is less specific. | * Fat or hemorrhage can easily be identified on unenhanced images, and delayed-phase images demonstrate the tendency for fibrotic components to enhance and retain contrast material. * Because adenomas consist almost entirely of uniform hepatocytes and a variable number of Kupffer cells, most adenomas are nearly isoattenuating relative to normal liver on unenhanced, portal venous–phase, and delayed-phase images. * In patients with fatty liver, adenomas are hyperattenuating at all phases of contrast enhancement and on unenhanced images as well. * Small hepatocellular adenomas enhance rapidly and are hyperattenuating relative to the liver. * Excluding lesions with acute or old tumor hemorrhage and fat deposition, hepatocellular adenoma demonstrated homogeneous or nearly homogeneous enhancement in approx 80% of cases. ** The enhancement usually does not persist in adenomas because of arteriovenous shunting. * Larger hepatocellular adenomas may be more heterogeneous than smaller lesions, and their CT appearance is less specific. | ||
===Magnetic Resonance Imaging=== | |||
==Treatment== | ==Treatment== | ||
Revision as of 01:34, 7 April 2009
| Hepatocellular adenoma | |
| ICD-O: | Template:ICDO |
|---|---|
| DiseasesDB | 5726 |
| eMedicine | med/48 |
| MeSH | D018248 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Hepatocellular adenoma, also hepatic adenoma, or rarely hepadenoma, is an uncommon benign liver tumour which is associated with the use of types of hormonal contraception with a high estrogen content.[1]
Diagnosis
MRI is the most useful investigation in the diagnosis and workup.[2]
Diagnostic Findings
Ultrasonography
- Color Doppler US may demonstrate peripheral peritumoral vessels and intratumoral vessels that typically have a flat continuous or, less commonly, triphasic waveform. *These Doppler US features are reported to be absent in the vessels within focal nodular hyperplasia and may be useful in distinguishing the two disease entities. *Nevertheless, most adenomas are not specifically diagnosed at US and are usually further evaluated with CT or other imaging modalities.
Computed Tomography
- Fat or hemorrhage can easily be identified on unenhanced images, and delayed-phase images demonstrate the tendency for fibrotic components to enhance and retain contrast material. * Because adenomas consist almost entirely of uniform hepatocytes and a variable number of Kupffer cells, most adenomas are nearly isoattenuating relative to normal liver on unenhanced, portal venous–phase, and delayed-phase images. * In patients with fatty liver, adenomas are hyperattenuating at all phases of contrast enhancement and on unenhanced images as well. * Small hepatocellular adenomas enhance rapidly and are hyperattenuating relative to the liver. * Excluding lesions with acute or old tumor hemorrhage and fat deposition, hepatocellular adenoma demonstrated homogeneous or nearly homogeneous enhancement in approx 80% of cases. ** The enhancement usually does not persist in adenomas because of arteriovenous shunting. * Larger hepatocellular adenomas may be more heterogeneous than smaller lesions, and their CT appearance is less specific.
Magnetic Resonance Imaging
Treatment
All hepatocellular adenoma should be surgically resected, because of the risk of rupture causing bleeding and because they may contain malignant foci.[3]
References
- ↑ Rooks J, Ory H, Ishak K, Strauss L, Greenspan J, Hill A, Tyler C (1979). "Epidemiology of hepatocellular adenoma. The role of oral contraceptive use". JAMA. 242 (7): 644–8. PMID 221698.
- ↑ Hussain S, van den Bos I, Dwarkasing R, Kuiper J, den Hollander J (2006). "Hepatocellular adenoma: findings at state-of-the-art magnetic resonance imaging, ultrasound, computed tomography and pathologic analysis". Eur Radiol. 16 (9): 1873–86. PMID 16708218.
- ↑ Toso C, Majno P, Andres A, Rubbia-Brandt L, Berney T, Buhler L, Morel P, Mentha G (2005). "Management of hepatocellular adenoma: solitary-uncomplicated, multiple and ruptured tumors". World J Gastroenterol. 11 (36): 5691–5. PMID 16237767.Full text