Gut Liver.  2009 Sep;3(3):226-230.

Discrete Hypoechoic Ring in Hepatic Cavernous Hemangioma Resembling a Malignant Tumor: Correlation with Histologic Features

• Choi JC
• Baek YH
• Jeong JS
• Lee SW
• Han SY
• Cho JH

Abstract

Differential diagnoses of hepatic nodules include hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenoma, regenerative nodule, focal fatty changes, and hemangioma. However, differentiation of these nodules can often be difficult. Hemangiomas are frequently encountered during ultrasonogram incidentally and can be diagnosed easily because they have an almost distinctive sonographic appearance: a homogeneous hyperechogenicity and discrete posterior acoustic enhancement. They also sometimes have atypical findings, for example an internal echogenicity including hypoechogenicity, heterogeneous echogenicity, hyperechoic rim, central hypoechogenicity due to various changes (e.g., internal hemorrhage, necrosis, thrombosis, myxomatous change, and fibrosis), and (rarely) calcification. We report herein the case of an atypical hemangioma presenting with a hypoechoic peripheral ring, mimicking a hepatic malignancy. To our knowledge, there have been no other reports demonstrating a cavernous hemangioma with a discrete hypoechoic ring and without a pseudocapsule.

Keyword

Hemangioma; Hypoechoic ring; Hepatic malignancy; Ultrasonography

MeSH Terms

Acoustics
Adenoma
Carcinoma, Hepatocellular
Caves
Diagnosis, Differential
Focal Nodular Hyperplasia
Hemangioma
Hemangioma, Cavernous
Hemorrhage
Necrosis
Thrombosis