title: Fibrolamellar hepatocellular carcinoma: imaging and pathologic findings in 31 recent cases.
abstract: OBJECTIVE
  To review characteristic findings of fibrolamellar hepatocellular carcinoma (HCC) at computed tomography (CT) and magnetic resonance (MR) imaging.
  
  
  METHODS
  The authors retrospectively reviewed the clinical, pathologic, and preoperative imaging findings in 31 patients with histologically proved fibrolamellar HCC. Dynamic contrast material-enhanced CT of the liver was performed in 31 patients, helical multiphase CT in 21, and MR imaging in 11. Complete resection was performed in 17 patients, and imaging-pathologic correlation was performed.
  
  
  RESULTS
  Large tumors (mean diameter, 13 cm) were depicted at CT and MR in all cases. At CT, the margins of the tumors were well defined in 24 (77%) of 31 cases calcifications were depicted in 21 (68%), a central scar in 22 (71%), and abdominal lymphadenopathy in 20 (65%). In 20 (80%) of 25 cases with hepatic arterial phase CT images, all tumors were heterogeneous and depicted areas of hypervascularity. At MR imaging, tumors were hypointense to liver on T1-weighted images (n = 11) and hyperintense to liver on T2-weighted images (n = 10). Calcification was not depicted on MR images, but a central scar was depicted as hypointense to surrounding tumor in nine cases.
  
  
  CONCLUSIONS
  CT and MR images demonstrate characteristic features that may allow confident diagnosis of fibrolamellar HCC.
authors.affiliation: Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
authors.forename: T
authors.initials: T
authors.lastname: Ichikawa
authors.forename: M P
authors.initials: MP
authors.lastname: Federle
authors.forename: L
authors.initials: L
authors.lastname: Grazioli
authors.forename: J
authors.initials: J
authors.lastname: Madariaga
authors.forename: M
authors.initials: M
authors.lastname: Nalesnik
authors.forename: W
authors.initials: W
authors.lastname: Marsh
mesh_terms: D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed