Hepatic adenoma
Case contributed by:
Dr Natalie Yang
From the case:
Hepatic adenoma
Modality:
Ultrasound
Hepatic Adenoma Us
Ultrasound demonstrates of hyperechoic lesion with attenuation of the beam suggesting possible fat content The ultrasound appearances of hepatic adenomas is variable and differentiation from other liver lesions such as FNH or HCC is usually not possible on grey scale or Doppler characteristics
From the case:
Hepatic adenoma
Modality:
CT
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Hepatic Adenoma Ct Arterial
CT demonstrates the lesion contains areas of macroscopic fat, with early arterial enhancement with variable lesional washout on portal venous phase scanning Fat is demonstrated on CT in 7% of cases; Coarse calcifications seen on CT in 5%; Hyperdense hemorrhage is seen in up to 40%
From the case:
Hepatic adenoma
Modality:
MRI
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Hepatic Adenoma T1 Out Of Phase
Fat within a hepatic adenoma results in signal loss on the T1 opposed phase scans. The presence of haemorrhage results in variable T1 and T2 signal intensity but will often be high signal as a result.Case Discussion:
Pathology proven hepatic adenoma
Hepatic Adenomas are benign epithelial neoplasm
- Most commonly solitary (multiplicity may suggest liver adenomatosis)
- Richly vascular tumor which frequently contains hemorrhage and necrosis
- Pseudocapsule derived from compressed/collapsed hepatic parenchyma
- Histological hallmark are clusters of benign hepatocytes arranged in sheets or cords with absent bile ducts
- Adenomas have variable lipid content ranging from
- Microscopic fat (detected in up to 77% with chemical shift MR) to
- Macroscopic fat (detected at CT in up 7%)
90% of hepatic adenomas occur in womenAssociations with:
- Oral contraceptive use
- Anabolic steroids
- Glycogen storage disease (Type 1a)
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