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Hemangioma in a cirrhotic liver

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Cirrhotic patient with a hypoechoic liver mass detected at ultrasonography.

Patient Data

Age: 50 years
Gender: Male
  • liver cirrhosis, portal hypertension with esophageal varices and splenomegaly.
  • within the right liver lobe segment V, there is a 2 X 2 cm lesion with hypointense T1 and mildly hyperintense T2/ heavily T2 signal. 
  • dynamic contrast-enhanced series shows a hypervascular lesion at the right liver lobe segment V with nodular enhancement in the arterial phase. 
  • the lesion shows persistent enhancement at the portal, venous and delayed phases with centripetal filling in. 
  • no wash-out of the contrast is noted. 
  • note also the right liver lobe wedge shaped and sub capsular transient hepatic enhancement in the arterial phase just posterior the aforementioned hepatic focal lesion; representing a non-tumorous arterio-portal (AP) shunt. 

Case Discussion

Hemangioma in a cirrhotic liver. A confident diagnosis of pre-existing hepatic hemangioma in cirrhotic liver was made and the typical imaging criteria preclude the need for biopsy.

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