Unusual Hepatic Lesion with Fat Fluid Level – Imaging Findings and Review of Literature (original) (raw)

Fat-containing liver lesions: a pictorial review

Radiologia brasileira

The aim of this pictorial essay is to review the spectrum of fat-containing liver lesions and their characterisation on magnetic resonance imaging with focus on the radiological features that aid in the differential diagnoses. Fat-containing liver lesions comprise a heterogeneous group of tumours with variable imaging findings. Magnetic resonance imaging clearly displays the micro- and macroscopic fat components of the lesions and other characteristic features that are helpful tools to make the differential diagnosis.

Fat-containing lesions of the liver : A pictorial essay

Diagnostic and Interventional Imaging, 2015

The presence of fat within a hepatic lesion is unusual and can help to direct the radiologist's diagnosis. The aim of this iconographic review is to specify the various hepatic lesions that may contain fat and their appearance particularly on MRI. A histological correlation is also suggested for the most commonly found tumors. The identification of fat within a hepatic tumor, along with other radiological signs and reflection on the clinical and epidemiological context, can lead to a diagnosis being reached or suggested, with confirmation if necessary, by a pathological examination.

Hepatic Lipoma: Radiological Imaging Findings

Surgical Science, 2011

Hemangiomas and hepatic metastases are the leading reasons of echogenic masses on ultrasound (US) evaluation of the liver. Lipomas of the liver are extremely rare and have been sporadically reported in the literature during the last century. The present report describes a patient with hepatic lipoma together with liver metastases from gastric adenocarcinoma. A 54 years old woman was refered to our department because of abdominal pain. Patient has been operated for gastric adenocarcinoma 3 months ago she was evaluated with US, computed tomography (CT) and magnetic resonance imaging (MRI).The abdominal US revealed a 12 × 10 mm echogenic mass with smooth borders in 7th segment of the liver. CT scan showed a hypodense lesion in the same hepatic segment with fat dencity and no contrast involvement. MRI demonstrated the same lesion on T1 and T2 weighted images as hyperintence mass. The final radiographic diagnosis was hepatic lipoma. However, there was metastas in the liver of patient. Patient died 4 months later due to metastatic gastric adenocarcinoma. Hepatic lipoma should be kept in mind in echogenic masses on US evaluation of the liver.

Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging

European Radiology, 2000

ocal nodular fatty infiltration of the liver is a pseudotumor visualized as a highly echoic lesion on sonography. On computed tomography (CT), focal nodular fatty infiltration is generally characterized by a low-density area with no mass effect. 1 Although focal nodular fatty infiltration must be differentiated from primary liver cancer, a metastatic liver tumor, or hepatic hemangioma, this can be difficult with CT or sonography alone. When differential diagnosis is difficult from imaging investigations alone, biopsy proof of the tumor is necessary before therapy is commenced. The appearance of numerous small multifocal nodular fatty infiltrations in both hepatic lobes may mimic that of metastatic liver disease, leading to incorrect therapy. Particularly if the patient has had malignant disease in the past, multifocal nodular fatty infiltrations may be misdiagnosed, and incorrect therapy may be performed without adequate examination or differential diagnosis of the primary lesion. Although magnetic resonance imaging (MRI) and fine-needle biopsy are reportedly useful in diagnosing focal fatty infiltration of the liver, 2-4 the value of enhanced sonography has not been reported in this situation. We encountered a case of multifocal nodular fatty infiltration in which findings of the late parenchymal phase of enhanced sonography with Levovist (SH U 508A; Schering AG, Berlin, Germany) were useful in ruling out malignancy.

Fat Containing HCC

Acad Radiol, 2009

The purpose of this article is to review the spectrum of computed tomography (CT) and magnetic resonance imaging (MRI) findings of fat containing hepatocellular carcinoma (HCC), including serial contrast–enhanced imaging.Imaging findings of 10 fat-containing HCCs on CT (n = 2) or MRI (n = 3) or on both CT and MRI (n = 5) were retrospectively reviewed in 9 patients. Both techniques included serial contrast enhanced imaging in arterial, portal venous, and late venous phases.On non-contrast CT, fat containing HCC was either homogenously hypodense (n = 6) or of mixed density (n = 1). The density values ranged between −11 and 9 HU. On MRI, homogenous (n = 4) or heterogenous (n = 4) signal loss was observed on T1-weighted out-of-phase images as compared to in-phase images. Enhancement patterns on serial contrast–enhanced CT and MRI included: arterial enhancement indistinguishable from the liver with venous wash out (n = 2), arterial capillary blush with venous phase fading (n = 2), and heterogenous arterial enhancement with unenhanced foci and venous phase wash out of enhancements. Larger lesions had late capsular enhancement.Fat containing HCC has spectrum of imaging findings on CT and MRI. MRI with chemical shift technique depicts the fat content. Arterial contrast enhancement with venous washout or fading may help for the diagnosis of HCC in inconclusive cases.

Diagnosis of fatty liver disease

European Journal of Gastroenterology & Hepatology, 2003

Non-alcoholic fatty liver disease is increasingly being recognized as an important and common condition, affecting approximately 20% of the general population. Although liver biopsy is currently the gold standard for diagnosis, there is a need for less invasive methods. Imaging by ultrasound, computerized tomography and magnetic resonance are all able to demonstrate fat. In this paper, these three imaging techniques are critically assessed. Ultrasound, although probably not the most reliable imaging method, has many advantages and, when positive, gives a high degree of certainty of the diagnosis depending on the prevalence of fatty liver in the population being studied. Unlike liver biopsy, none of these techniques is able to differentiate simple steatosis from non-alcoholic steatohepatitis.