Well-to moderately-differentiated HCC manifesting hyperattenuation on both CT during arteriography and arterial portography.
We present a rare case of well- to moderately-differentiated hepatocellular carcinoma (HCC) in a 71-year-old woman with hepatitis C virus-related cirrhosis and unusual radiologic features. A 20-mm hypoechoic nodule disclosed by ultrasound in segment two showed hyperattenuation on both computed tomography hepatic arteriography and computed tomography during arterial portography. Contrast-enhanced ultrasound revealed hypervascularity in the early vascular phase and defect in the post-vascular phase, with the same pattern detected by the two imaging techniques. SPIO-MRI revealed a hyperintense nodule. These findings were compatible with those of moderately-differentiated HCC. An ultrasound-guided biopsy showed histological features of well- to moderately-differentiated HCC characterized by more than two-fold the cellularity of the non-tumorous area, fatty change, clear cell change and mild cell atypia with a thin to mid-trabecular pattern. Further studies may provide insights into the correlation between tumor neovascularity in multistep hepatocarcinogenesis and dual hemodynamics, including the artery and the portal vein.
Kim
Soo Ryang
SR
Department of Gastroenterology, Kobe Asahi Hospital, 3-5-25 Bououji-cho, Nagata-ku, Kobe 653-0801, Japan. info@kobe-asahi-hp.com
Imoto
Susumu
S
Ikawa
Hirotsugu
H
Ando
Kenji
K
Mita
Keiji
K
Fuki
Shuichi
S
Sakamoto
Michiie
M
Kanbara
Yoshihiro
Y
Matsuoka
Toshiyuki
T
Kudo
Masatoshi
M
Hayashi
Yoshitake
Y
D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D016174:Hepacivirus; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006526:Hepatitis C / Q000473:pathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D011172:Portography; D014057:Tomography, X-Ray Computed