Hepatocellular carcinoma with a "nodule-in-nodule" appearance reflecting an unusual dilated pseudoglandular structure.
We present a case of hepatocellular carcinoma (HCC), showing an atypical "nodule-in-nodule" appearance on ultrasonogram (US). In general, a "nodule-in-nodule" appearance is found as a hyperechoic tumor containing a hypoechoic nodule. In the present case, however, there was a hyperechoic subnodule in the center of the tumor, which was surrounded by a hypoechoic tumor area. Histologically, the subnodule consisted of moderately differentiated HCC with a markedly dilated pseudoglandular structure, and the outer tumor consisted of well-differentiated HCC with a thin-trabecular pattern. It should be noted that there is a rare HCC with dilated pseudoglandular structure showing the inversed "nodule-in-nodule" appearance.
Ishida
Yusuke
Y
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Karume, Japan. ishida_yuusuke@kurume-u.ac.jp
Nagamatsu
Hiroaki
H
Koga
Hironori
H
Yoshida
Hiroshi
H
Kojiro
Masamichi
M
Sata
Michio
M
D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography