title: Discrete hypoechoic ring in hepatic cavernous hemangioma resembling a malignant tumor: correlation with histologic features.
abstract: Differential diagnoses of hepatic nodules include hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenoma, regenerative nodule, focal fatty changes, and hemangioma. However, differentiation of these nodules can often be difficult. Hemangiomas are frequently encountered during ultrasonogram incidentally and can be diagnosed easily because they have an almost distinctive sonographic appearance: a homogeneous hyperechogenicity and discrete posterior acoustic enhancement. They also sometimes have atypical findings, for example an internal echogenicity including hypoechogenicity, heterogeneous echogenicity, hyperechoic rim, central hypoechogenicity due to various changes (e.g., internal hemorrhage, necrosis, thrombosis, myxomatous change, and fibrosis), and (rarely) calcification. We report herein the case of an atypical hemangioma presenting with a hypoechoic peripheral ring, mimicking a hepatic malignancy. To our knowledge, there have been no other reports demonstrating a cavernous hemangioma with a discrete hypoechoic ring and without a pseudocapsule.
authors.affiliation: Department of Diagnostic Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jong Cheol
authors.initials: JC
authors.lastname: Choi
authors.forename: Yang-Hyun
authors.initials: YH
authors.lastname: Baek
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Jeong
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Han
authors.forename: Jin Han
authors.initials: JH
authors.lastname: Cho