title: Hemodynamics and progression of a hypervascular focus in a borderline lesion of hepatocellular carcinoma: analysis by angiography-assisted CT and histopathology.
abstract: OBJECTIVE
  To investigate the hemodynamics and progression of a hypervascular focus (HF) in a borderline lesion by dual-phase CT during hepatic arteriography (CTHA) and reveal the process of the transformation to hypervascular overt hepatocellular carcinoma (HCC).
  
  
  METHODS
  This study was performed with the approval of our institutional ethics committee, and informed consent for the retrospective usage of clinical materials was obtained from all the patients. The 121 nodules in 76 consecutive patients with liver cirrhosis and chronic hepatitis showing an HF in a borderline lesion on angiography-assisted CT were analyzed. Hemodynamic changes were observed in 24 patients who underwent repeated angiography-assisted CT. Histopathological analysis was conducted in eight nodules.
  
  
  RESULTS
  HF was classifiable into type A (stain disappeared), B (stain prolonged), C (stain was washed out and corona-like drainage into the outer nodule was seen) and D (stain was washed out and corona-like drainage into the whole outer nodule was seen) on the late phase of CTHA and was seen to progress in this order on follow-up observation. Histopathologically, de-differentiated foci showed significantly higher expression of sinusoidal capillarization and unpaired arteries than background nodules and showed pseudocapsule, compressive and replacing growth at the border of the background nodule.
  
  
  CONCLUSIONS
  HF showed multi-step progression and transformation to hypervascular overt HCC.
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, 920-8641, Japan, entamamail@yahoo.co.jp.
authors: Tamao
authors: T
authors: Endo
authors: Kazuto
authors: K
authors: Kozaka
authors: Satoshi
authors: S
authors: Kobayashi
authors: Junichiro
authors: J
authors: Sanada
authors: Wataru
authors: W
authors: Koda
authors: Tetsuya
authors: T
authors: Minami
authors: Azusa
authors: A
authors: Kitao
authors: Norihide
authors: N
authors: Yoneda
authors: Yasuni
authors: Y
authors: Nakanuma
authors: Toshifumi
authors: T
authors: Gabata
authors: Osamu
authors: O
authors: Matsui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed