Multifocal hepatocellular carcinoma
Liver cirrhosis with high alpha fetoprotein and mutiple hepatic foci on ultrasound.
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Triphasic CT of the liver demonstrates the following:
Enlarged cirrhotic liver. Multisegmental right hepatic lobe focals with faint homogenous wash in of contrast in arterial phase and washout in venous and delayed phases.
Completely occluded of the portal vein lumen as well as its main branches with thrombosis.
Mild abdominal ascites. Enlarged spleen. Small left kidney.
70 years old male patient with liver cirrhosis, US of the abdomen (not included) showed multiple right hepatic lobe focal lesions together with elevated alpha fetoprotein levels.
CT shows multifocal liver lesions together with portal vein thrombosis, splenomegaly and ascites. Features are most suggestive of hepatocellular carcinoma.