Hemangioma-like lesions in chronic liver disease: Diagnostic evaluation in patients

E. Caturelli, M. Pompili, F. Bartolucci, D. A. Siena, M. Sperandeo, A. Andriulli, M. Bisceglia

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To quantify the risk of misdiagnosis of focal hepatic lesions manifesting at ultrasonography (US) as typical hemangiomas in a population at high risk for hepatocellular carcinoma (HCC) and to identify the most effective approach to their diagnostic evaluation. MATERIALS AND METHODS: A total of 1,982 patients with newly diagnosed cirrhosis underwent US and serum α-fetoprotein determinations for early detection of HCC. Focal lesions with typical features of hemangioma were evaluated with confirmatory findings of contrast material-enhanced dynamic or spiral computed tomography (CT) and/or single photon emission CT with technetium 99m-labeled red blood cells and, in the absence of confirmatory imaging findings, US-guided fine-needle biopsy. Patients whose initial US scan depicted no lesions or hemangiomas were enrolled in a US follow-up program. All hemangioma-like lesions detected during follow-up were evaluated, or biopsy was performed. RESULTS: US depicted hemangioma-like lesions in 44 of 1,982 patients: 22 hemangiomas and 22 HCCs. Hemangioma-like lesions detected during follow-up in 1,648 patients were HCCs (n = 22) or dysplastic nodules (n = 4). Only 85 (22%) of 383 patients with HCC had α-fetoprotein levels suggestive of the diagnosis. The probability of a diagnosis of HCC (or preneoplastic lesion) is 100% for hemangioma-like lesions depicted on subsequent US scans. CONCLUSION: If initial US examination of a cirrhotic liver depicts a hemangioma, confirmatory findings of imaging studies are necessary since 50% of hemangiomas in this study were hyperechogenic HCCs. US-guided biopsy can be safely performed, and its findings can be used to confirm the diagnosis.

Original languageEnglish
Pages (from-to)337-342
Number of pages6
JournalRadiology
Volume220
Issue number2
Publication statusPublished - 2001

Keywords

  • Angioma, 761.3194
  • Liver neoplasms, 761.323
  • Liver, CT, 761.12112, 761.12115
  • Liver, SPECT, 761.12162
  • Liver, US, 761.12981

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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