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Hepatic Haemangioma Image 1 (Computed Tomography): Post-contrast images demonstrating initial peripheral enhancement, followed by delayed filling of the lesion with contrast. These features are typical of a haemangioma. |
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| 2a |
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Hepatic Haemangioma Image 2a, 2b and 2c (Triphasic Computed Tomography): Non-contrast scan (Image 2a) demonstrates a subtle low attenuation lesion in segment 6 of the liver (arrow). There is globular peripheral enhancement of the lesion in the post contrast arterial phase scan (Image 2b) with delayed filling in of the lesion in the portal venous phase (Image 2c). |
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| 2b |
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| 2c |
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| 2d |  |
Image 2d (Ultrasound): Ultrasound scan demonstrating the liver lesion in same patient. |
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| 3a |
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Hepatic Haemangioma Image 3a (H&E, x2.5): Histological section of a hepatic haemangioma showing variously sized, dilated and congested blood vessels set in a fibrous stroma with residual islands of liver parenchyma. |
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| 4a |
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Hepatic Adenoma Image 4a and 4b (Computed Tomography): Coronal and axial views demonstrating several enhancing liver lesions. |
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| 4c |
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Image 4c (Ultrasound): Ultrasound scan demonstrating the liver lesions in same patient. |
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| 5a |
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Hepatic Focal Nodular Hyperplasia Image 5a and 5b (Triphasic Computed Tomography): The arterial phase scan (Image 5a) shows a hyperattenuating nodular lesion (narrow arrow) with the typical central scar (broad arrow) in segment 4 of the liver. On the delayed portal venous phase (Image 5b), the lesion becomes isoattenuating (arrow). |
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| 5b |
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| 6a |
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Hepatic Focal Nodular Hyperplasia Image 6a, 6b, 6c and 6d (Magnetic Resonance Imaging): Gadolinium-enhanced T1-weighted MRI (Image 6a) demonstrates an ill-defined low-signal intensity mass in segment 4 of the liver with intense enhancement in the arterial phase (Image 6b). Minor enhancement persists in the portal venous phase (Image 6c) and the lesion becomes isointense with enhancement of the central scar (arrow) on the delayed image (Image 6d). |
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| 6b |
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| 6c |
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| 6d |
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| 7 |
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Simple Hepatic Cyst Image 7 (Ultrasound): Simple-appearing cyst in the left lobe of liver. |
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| 8a |  |
Hepatocellular Carcinoma Image 8a and 8b (Ultrasound): Within segment 6 of the liver, there is an approximately 2cm subcapsular hypoechoic lesion (arrow) which does not demonstrate any increased vascularity. |
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| 8b | |
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| 8c |  |
Image 8c, 8d, 8e and 8f (Triphasic Computed Tomography): CT of the same patient
shows a cirrhotic liver with patent hepatic and portal veins as well as
ascites. Within segment 6, there is a nodular area which demonstrates
slight enhancement corresponding to the lesion identified on ultrasound (arrow).
This lesion could represent either a dysplastic
cirrhotic nodule or an early hepatocellular carcinoma. |
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| 8e |  |
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| 8f |  |
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| 8g |
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Image 8g, 8h, 8i and 8j (Magnetic Resonance
Imaging): MRI of the same patient demonstrates a lesion measuring approximately 2.5 cm in diameter on the inferomedial aspect of segment 5 in a subcapsular
location. This is bulging
the capsule of the liver at the level of the upper pole of the right kidney.
The lesion is essentially isointense to the rest of the liver on T1 weighted
imaging (out of phase) but is slightly hyperintense on in-phase imaging
suggesting that the rest of the liver has some fatty infiltration. The
lesion is slightly hyperintense on first echo T2 but is not clearly visible
on more heavily weighted T2 imaging. The lesion shows arterial enhancement
but washes out in the portal venous phase, with the rim of the lesion
remaining enhanced. The appearances are consistent with a hepatocellular carcinoma.
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| 8h |
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| 8i |
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| 8j |
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| 9a |
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Hepatocellular Carcinoma Image 9a and 9b : Hepatectomy specimens showing a multifocal hepatocellular carcinoma with areas of necrosis and haemorrhage arising in a cirrhotic liver. |
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| 9b |
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| 9c |
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Image 9c (H&E, x2.5) and 9d (H&E, x10): Histological sections of a hepatocellular carcinoma arising on a background of cirrhosis. The usual lobular architecture is replaced by irregular and thickened trabeculae of malignant hepatocytes. There is mild nuclear pleomorphism. | ||
| 9d |
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Pathology
images courtesy of PathWest Laboratory Medicine.