A Case of Hypervascular Hyperplastic Nodules in a Patient with Alcoholic Liver Cirrhosis.
10.3349/ymj.2006.47.6.881
- Author:
Jae Hoon MOON
1
;
Chul Min AHN
;
Hyun Soo CHUNG
;
Sang Hoon AHN
;
Young Nyun PARK
Author Information
1. Departments of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Hypervascular hyperplastic nodule;
alcoholic liver cirrhosis;
hepatocellular carcinoma
- MeSH:
Tomography, X-Ray Computed;
Male;
Liver Neoplasms/diagnosis;
Liver Cirrhosis, Alcoholic/*complications;
Liver/*pathology/radiography/ultrastructure;
Hyperplasia;
Humans;
Diagnosis, Differential;
Carcinoma, Hepatocellular/diagnosis;
Biopsy;
Adult
- From:Yonsei Medical Journal
2006;47(6):881-886
- CountryRepublic of Korea
- Language:English
-
Abstract:
Most hypervascular nodules in a cirrhotic liver are hepatocellular carcinomas (HCCs); however, some are benign hypervascular hyperplastic nodules. We report a case of benign hypervascular hyperplastic nodules in a 41-year-old male patient without hepatitis B or C virus infection, with a history of alcohol abuse, and diagnosed with an aortic aneurysm. The dynamic computerized tomography of the liver demonstrated multiple nodular lesions on both liver lobes with arterial enhancement and delayed washout. The hepatic angiography showed multiple faint nodular staining of both lobes in the early arterial phase. Magnetic resonance imaging revealed numerous nodules showing high signals on T1 weighted images, with some nodules showing a low central signal portion. The clinical impression was HCC. The ultrasonography-guided liver biopsy, which was performed on the largest nodule (2.5 cm in size), revealed hepatocellular nodules with slightly increased cellularity, unpaired arteries, increased sinusoidal capillarization, and focal iron deposition. However, both cellular and cytological atypia were unremarkable. Although the clinical impression was HCC, the pathological diagnosis was hypervascular hyperplastic nodules in alcoholic cirrhosis. Differential diagnosis of hypervascular nodules in cirrhosis and HCC is difficult with imaging studies; thus, histological confirmation is mandatory.
