Learning objectives
The correlation between the imaging aspects and the histopathology features is,
actually,
the best and fastest way to achieve an accurate diagnosis of hepatocelular adenomas(HCA).
With this presentation we propose to achieve these objectives:
To illustrate and describe the imaging features of hepatocelular adenomas.
To compare the roles of computed tomography-(CT) and magnetic resonance-(MR) in the evaluation of hepatocelular adenomas.
To correlate the imaging findings with histopathologic features.
Background
Hepatocellular adenomas are rare,
benign tumors of cells closely resembling to normal hepatocytes.
These tumors are seen predominantly in young women,
especially when using oral contraceptive pills.
They can be located in the right or left hepatic lobe,
and are typically solitary (70-80%).
(3) Multiple adenomas have been described in patients with prolonged contraceptive use and glycogen storage diseases (GSD),
in which case we speak of hepatocellular adenomatosis.
(1) Hepatocellular adenoma can also be found in men who are receiving anabolic steroid therapy.
(2)
The...
Imaging findings OR Procedure details
Computed Tomography:
The main advantage of CT scans is to allow a more accurate detection and a better characterization of focal hepatic lesions.
(3)
The comparison of theHCArelative to the liver depends on the composition of the tumor and of the liver as well as on the phase of contrast material enhancement.
Using a 16-slice helical CT,non-enhanced images are the first to be obtained.
Then,
after the injection of intravenous non ionic contrast (120-150ml at a rate of 3-5mL/s with a 25 to 30s delay)...
Conclusion
CT and MRI can demonstrate imaging findings suggestive of hepatocelullar adenoma.
Due to the overlap of some of these characteristics with other hepatic tumors it is very important to better characterize these lesions so that we can achieve a quicker and more accurate diagnosis.
References
(1) - Ludger Barthelmes,
Ian S.
Tait,
Liver cell adenoma and liver cell adenomatosis,
HPB,
2005; 7: 186–196;
(2) - Luigi Grazioli,
Michael P.
Federle,
Tomoaki Ichikawa,
Eric Balzano,
Michael Nalesnik,
Juan Madariaga,Liver Adenomatosis: Clinical,
Histopathologic,
and Imaging Findings in 15 Patients,
Radiology,
2000,
216:395-402;
(3) - Luigi Grazioli,
Michael P.
Federle,
Giuseppe Brancatelli,
Tomoaki Ichikawa,
Lucio Olivetti,
Arye Blachar,
Hepatic Adenomas: Imaging and Pathologic Findings,
RadioGraphics 2001; 21:877–894;
(4) - Alvin C.
Silva,
James M.
Evans,
Ann E.
McCullough,
Mashal A.
Jatoi, Hugo E....