Clin Mol Hepatol.  2015 Dec;21(4):326-343. 10.3350/cmh.2015.21.4.326.

Imaging findings of mimickers of hepatocellular carcinoma

• Kim TK
• Lee E
• Jang HJ

• KMID: 2359813
• DOI: http://doi.org/10.3350/cmh.2015.21.4.326

Abstract

Radiological imaging plays a crucial role in the diagnosis of hepatocellular carcinoma (HCC) as the noninvasive diagnosis of HCC in high-risk patients by typical imaging findings alone is widely adopted in major practice guidelines for HCC. While imaging techniques have markedly improved in detecting small liver lesions, they often detect incidental benign liver lesions and non-hepatocellular malignancy that can be misdiagnosed as HCC. The most common mimicker of HCC in cirrhotic liver is nontumorous arterioportal shunts that are seen as focal hypervascular liver lesions on dynamic contrast-enhanced cross-sectional imaging. Rapidly enhancing hemangiomas can be easily misdiagnosed as HCC especially on MR imaging with liver-specific contrast agent. Focal inflammatory liver lesions mimic HCC by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging. It is important to recognize the suggestive imaging findings for intrahepatic cholangiocarcinoma (CC) as the management of CC is largely different from that of HCC. There are other benign mimickers of HCC such as angiomyolipomas and focal nodular hyperplasia-like nodules. Recognition of their typical imaging findings can reduce false-positive HCC diagnosis.

Keyword

Carcinoma, Hepatocellular; Liver; Diagnostic imaging; Benign neoplasms

MeSH Terms

Carcinoma, Hepatocellular/*diagnosis/radiography
Diagnosis, Differential
Hemangioma/complications/radiography/ultrasonography
Hepatitis B/complications
Humans
Inflammation/radiography/ultrasonography
Liver/radiography/ultrasonography
Liver Cirrhosis/complications/radiography
Liver Neoplasms/*diagnosis/radiography
Magnetic Resonance Imaging
Non-alcoholic Fatty Liver Disease/radiography/ultrasonography