Small hepatic nodules surrounding hepatocellular carcinoma.
OBJECTIVE
We investigated whether or not small hepatic nodules surrounding the main hepatocellular carcinoma were malignant, while also analyzing the role of intraoperative ultrasonography in detecting these small nodules.


METHODS
Thirty-three small hepatic nodules near the main tumor in 17 patients were retrospectively studied. They were first detected either during or after the operation using intraoperative ultrasonography and/or after examining a cross-section of the resected specimen.


RESULTS
Twenty-six of the 33 small nodules were shown to be malignant when studied histologically (79%). The reliability of intraoperative ultrasonography was higher than 80 per cent for detecting nodules measuring more than 5 mm in diameter. However, it was only 25 per cent reliable with smaller nodules measuring less than or equal to 5 mm.


CONCLUSIONS
These results suggest that most small hepatic nodules with hepatocellular carcinoma should be considered to be malignant. In addition, smaller nodules measuring less than 5 mm in size can hardly be detected by intraoperative ultrasonography.
Ezaki
T
T
Department of Surgery, Iizuka Hospital, Japan.
Koyanagi
N
N
Yamagata
M
M
Kajiyama
K
K
Maeda
T
T
Sugimachi
K
K
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007432:Intraoperative Period; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography