PURPOSE: The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). METHODS: Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multicentric small HCCs in 13 patients were histologically diagnosed in the resected specimens. High-frequency IOUS and pathologic findings of these lesions were compared, with particular focus on the presence and appearance of the capsule in or around each lesion. RESULTS: Synchronous multicentric small HCCs were pathologically classified into distinctly nodular (n=12) or vaguely nodular (n=4) types. All 12 distinctly nodular HCCs including six subcentimeter lesions showed detectable capsules on high-frequency IOUS and pathology. The capsules appeared as a hypoechoic rim containing hyperechoic foci (n=6), hypoechoic rim (n=5), or hyperechoic rim (n=1) with varying degrees of coverage around each lesion. Histologically, the capsules were composed of a combination of one to four layers consisting of a fibrous capsule, peritumoral fibrosis, prominent small vessels, and entrapped hepatic parenchyma. CONCLUSION: Synchronous multicentric small HCCs with distinctly nodular type, even at subcentimeter size, can show capsules with varying coverage and diverse echogenicity on high-frequency IOUS.
Capsules ; Carcinoma, Hepatocellular* ; Fibrosis ; Humans ; Liver Neoplasms ; Pathology ; Ultrasonography*

Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.
Humans ; Hemangioendothelioma, Epithelioid/pathology* ; Contrast Media ; Retrospective Studies ; Liver Neoplasms/pathology* ; Portal Vein/pathology* ; Ultrasonography

Imaging findings of secondary hepatic lymphoma have been reported as variable, ranging from single or multiple small nodules to diffuse infiltrative tumor patterns. We hear present a rare case report concerning aggressive B cells, secondary Burkitt's lymphoma in non-AIDS demonstrating a surprising periportal lymphoma infiltration, without upper abdominal lymphadenopathy or splenomegaly on the sonography and CT scans. Clinically, the case was characterized by atypical and highly aggressive course, with the patient presenting an abruptly developed obstructive jaundice with rapidly deteriorating hepatic function that could be indicative of cholestatic hepatitis, which differs in its clinical manifestations from hepatic lymphoma without functional deterioration in respect of its non-tissue destructive growth pattern. We suggest that hepatic lymphoma can sometimes be consistent with periportal infiltrating homogeneous mass, with no lymphadenopathy or splenomegaly on the imaging examination, with a predictable aggressive clinical course of the disease and poor prognosis.
Abdomen ; Burkitt Lymphoma/*pathology/ultrasonography ; Fatal Outcome ; Female ; Humans ; Liver Neoplasms/*pathology/ultrasonography ; Middle Aged ; Prognosis ; *Tomography, X-Ray Computed

We report an extremely rare case of a diffuse hepatic hemangiomatosis without extrahepatic involvement in an adult. The imaging findings of this tumor were similar to those of a hepatic hemangioma and included contrast enhancement with a centripetal filling pattern of the entire hepatic tumor on the delayed phase of a dynamic CT and inhomogeneous diffuse uptake of the entire tumor on blood-pool images obtained five hours later on a 99mTc-labeled red blood cell scan. Despite its rarity, diffuse hepatic hemangiomatosis can be suggested in adult patients with diffusely involved hepatic tumors showing the radiological findings of a hepatic hemangioma.
Adult ; Female ; Gated Blood-Pool Imaging ; Hemangioma/*diagnosis/pathology/ultrasonography ; Humans ; Liver Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

No abstract available.
Adult ; Carcinoma, Hepatocellular/diagnosis/pathology/ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Liver Neoplasms/diagnosis/pathology/ultrasonography ; Magnetic Resonance Imaging ; Peliosis Hepatis/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

Hepatocellular calcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. It is important to diagnose HCC exactly before management is attempted. But, the clinical presentations and radiologic findings of liver abscess, HCC, and metastatic tumor to the liver may be quite similar, and procedures such as serum tumor marker assay, computerized tomography, and ultrasonography of the liver cannot make a specific diagnosis. We report a case of HCC successfully diagnosed by surgery which was misconceived as liver abscess and not improved by medical treatment.
Carcinoma, Hepatocellular/complications/*diagnosis/pathology ; Humans ; Liver/ultrasonography ; Liver Abscess/complications/*diagnosis/pathology ; Liver Neoplasms/complications/*diagnosis/pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

Diffuse hepatic hemangiomatosis without extrahepatic lesions is extremely rare in adults. A case of diffuse hepatic hemangiomatosis involving right lobe in a 50-year-old woman was presented. The hemangiomatosis was demonstrated by ultrasonography, computerized tomography (CT) and magnetic resonance image (MRI), and was confirmed histopathologically. Although diffuse hepatic hemangiomatosis is a rare disease in adults, its diagnosis should be considered in patients with diffuse tumor growth in one or both hepatic lobes and distinguished from malignant tumors. The present case is the first documented case of diffuse hepatic hemangiomatosis in an adult in Korea.
Case Report ; Female ; Hemangioma, Cavernous/ultrasonography ; Hemangioma, Cavernous/surgery ; Hemangioma, Cavernous/radiography ; Hemangioma, Cavernous/pathology+ACo- ; Human ; Liver Neoplasms/ultrasonography ; Liver Neoplasms/surgery ; Liver Neoplasms/radiography ; Liver Neoplasms/pathology+ACo- ; Magnetic Resonance Imaging ; Middle Age ; Neoplasms, Multiple Primary/ultrasonography ; Neoplasms, Multiple Primary/surgery ; Neoplasms, Multiple Primary/radiography ; Neoplasms, Multiple Primary/pathology+ACo- ; Tomography, X-Ray Computed

Diffuse hepatic hemangiomatosis without extrahepatic lesions is extremely rare in adults. A case of diffuse hepatic hemangiomatosis involving right lobe in a 50-year-old woman was presented. The hemangiomatosis was demonstrated by ultrasonography, computerized tomography (CT) and magnetic resonance image (MRI), and was confirmed histopathologically. Although diffuse hepatic hemangiomatosis is a rare disease in adults, its diagnosis should be considered in patients with diffuse tumor growth in one or both hepatic lobes and distinguished from malignant tumors. The present case is the first documented case of diffuse hepatic hemangiomatosis in an adult in Korea.
Case Report ; Female ; Hemangioma, Cavernous/ultrasonography ; Hemangioma, Cavernous/surgery ; Hemangioma, Cavernous/radiography ; Hemangioma, Cavernous/pathology+ACo- ; Human ; Liver Neoplasms/ultrasonography ; Liver Neoplasms/surgery ; Liver Neoplasms/radiography ; Liver Neoplasms/pathology+ACo- ; Magnetic Resonance Imaging ; Middle Age ; Neoplasms, Multiple Primary/ultrasonography ; Neoplasms, Multiple Primary/surgery ; Neoplasms, Multiple Primary/radiography ; Neoplasms, Multiple Primary/pathology+ACo- ; Tomography, X-Ray Computed

Extrahepatic metastasis of hepatocellular carcinoma (HCC) is occasionally seen in the lung, bone, adrenal gland, and lymph nodes. It is well known that HCC sometimes invades the biliary system. Since there is no peritoneum between the gallbladder and the liver fossa, a gallbladder cancer easily invades the liver; however, HCC seldom invades the gallbladder because it rarely destroys the muscle layer or the collagen fibers of the gallbladder wall. Routes of gallbladder metastasis of HCC include direct invasion, extension to the biliary system, and invasion of the adjacent hepatic vascular system. Some cases of gallbladder metastasis of HCC without direct invasion have been reported. We report here a case of HCC that directly invaded the gallbladder, and that resembled gallbladder carcinoma invading the liver.
Adult ; Carcinoma, Hepatocellular/*diagnosis/pathology/ultrasonography ; Diagnosis, Differential ; Gallbladder Neoplasms/diagnosis/*secondary ; Humans ; Liver Neoplasms/*diagnosis/pathology/ultrasonography ; Male ; Neoplasm Invasiveness ; Tomography, X-Ray Computed

No abstract available.
Gastroscopy ; Glomus Tumor/pathology/*radiography/ultrasonography ; Hemangioma/radiography ; Humans ; Liver Neoplasms/radiography ; Male ; Middle Aged ; Stomach Neoplasms/pathology/*radiography/ultrasonography ; Tomography, X-Ray Computed