Synchronous multicentric small hepatocellular carcinomas: defining the capsule on high-frequency intraoperative ultrasonography with pathologic correlation.
- Author:
Jae Hong AHN
1
;
Dae Woon EOM
;
Dae Shick RYU
;
Man Soo PARK
;
Seung Mun JUNG
;
Kun Moo CHOI
;
Gab Jin CHEON
;
Soo Jung CHOI
;
Hyuk Jai JANG
Author Information
- Publication Type:Original Article
- Keywords: Liver neoplasms; Carcinoma, hepatocellular; Ultrasonography
- MeSH: Capsules; Carcinoma, Hepatocellular*; Fibrosis; Humans; Liver Neoplasms; Pathology; Ultrasonography*
- From: Ultrasonography 2016;35(4):335-344
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
