A Case of Hepatocellular Carcinoma which is Difficult to Differentiate from Focal Nodular Hyperplasia

Isamu Yamamoto, Keisuke Hamazaki, Yasuhiro Yunoki, Takanao Miyashima, Akira Gohchi, Kenichi Sakagami, Hisashi Mimura, Kunzo Orita

First Department of Surgery, Okayama University Medical School

A 52-year-old man with hypertension and chronic hepatitis was found SOL in the left lateral segment of the liver. Liver function tests gave no cirrhotic results on admission. Echogram showed central scar-like high echoic lesion in the eccentric part of low echoic mass. By fast scan of MRI the tumor showed lineal low signal intensity in a radiating fassion. CT and angiography gave no evidence of both HCC and FNHP athologically incomplete capsule, lack of bile ducts, and partial pseudograndular pattern suggested HCC, although lack of cholestasis and focal nodular growth suggested FNH. The scar-like lesion in echogram was recognized as a medular focal legion, and the stellate septum-like appearance in MRI was recognized to be blood vessels. These were considered to be the causes of difficulty of pre-operative differentiation between HCC and FNH.

Key words
low echoic area, well differentiated hepatocellular carcinoma, focal nodular hyperplasia

Reprint requests
Isamu Yamamoto Yamamoto Gastroenterological Clinic
1-278-2 Kasuga-cho, Fukuyama, 721 JAPAN

Accepted
November 19, 1990

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