Large echogenic liver mass, differential diagnoses, ultrasound and color Doppler imaging скачать в хорошем качестве

Large echogenic liver mass, differential diagnoses, ultrasound and color Doppler imaging

A 5 cm round hyperechoic mass in the left lobe of the liver in an elderly male patient, asymptomatic and poorly vascular on ultrasound, raises several differential diagnoses. Hemangiomas, the most common benign liver tumors, typically appear as well-defined, hyperechoic lesions with poor vascularity due to slow blood flow. Focal Nodular Hyperplasia (FNH), another benign lesion, may present as isoechoic or slightly hyperechoic with a central scar showing variable vascularity. Hepatic adenomas, often linked to hormonal influences, appear hyperechoic or isoechoic, sometimes with areas of hemorrhage or necrosis. Metastatic liver lesions, especially from colorectal cancer, can also be hyperechoic, although their echogenicity varies. They often display poor vascularity on Doppler ultrasound. Hepatocellular carcinoma (HCC), a primary malignant liver tumor, may appear hyperechoic, especially with fatty changes or fibrous stroma, and typically shows hypervascularity, although smaller or well-differentiated tumors may not. Intrahepatic cholangiocarcinoma, another primary liver malignancy, can present as a hyperechoic mass with poor vascularity and ill-defined margins. Lastly, complex liver cysts, if hemorrhagic or infected, might appear hyperechoic, although they are generally avascular. Further imaging, such as contrast-enhanced ultrasound, CT, MRI, or biopsy, is essential to refine the diagnosis and determine the appropriate management strategy.