Hepatocellular adenoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

Hepatocellular adenoma must be differentiated from other diseases such as hepatocellular carcinoma, focal nodular hyperplasia, liver metastases (hypervascular), hemangioma of the liver, fibrolamellar hepatocellular carcinoma.

Hepatocellular adenoma differential diagnosis

Radiological differential diagnosis

Hepatocellular adenoma must be differentiated from other diseases such as:

• Hepatocellular carcinoma

• Washout tends to leave the lesion hypointense c.f. to rest of liver
• Rim enhancement of pseudocapsule may persist on delayed scan
• Different demographics
• May be difficult to distinguish if well differentiated

• Fibrolamellar hepatocellular carcinoma

• Radiating/central scar
• Calcification more common
• Lymph node enlargement common

• Focal nodular hyperplasia

• T2: bright central scars that have late enhancement
• US: may be difficult to differentiate adenoma from FNH on nonenhanced ultrasound

• Liver metastases (hypervascular)

• Usually hypointense on T1, and moderately hyperintense on T2
• Fat and haemorrhage are less common

• Hemangioma of the liver

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