Liver mass classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2] Aditya Ganti M.B.B.S. [3]
Overview
A liver mass may be grouped into several subtypes based on the number of nodules (solitary or multiple), type of histopathology (benign or malignant), and consistency (solid or cystic).
Classification
A liver mass may be classified into several sub-types based on number of nodules, type of histo-pathology, and consistency.[1][2][3][4][5][6][7][8][9][10][11]
| Liver mass | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Based on number of nodules | Type of histopathology | Imaging/consistency | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Solitary | Multiple | Benign | Malignant | Solid | Cystic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
CLassification based on the number of nodules
- Liver mass based on the number of nodules on imaging can be classified into 2 types:
- Solitary nodule
- Multiple nodules
| Solid liver mass | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No history of liver disease | History of liver disease | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Asymptomatic | Symptomatic | Arterial enchancement with washout | Only arterial enchancement | Persistant arterial enhancement | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Weight loss | HCC | Dyspatic nodule | Cholangiocarcinoma | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Adenoma | FNH* | Hemangioma | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Metastasis H/O of cancer | Fibrolammellar HCC No H/O of cancer | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Abbreviations:
- FNH: Focal nodular hyperplasia
Classification based on histopathology
- Based on the type of histopathology, liver mass can be classified into 2 types:
- Benign
- Malignant
| WHO Classification of Liver Tumors | |||
|---|---|---|---|
| Benign Tumors | Malignant Tumors | ||
| Epithelial | Hepatocytes |
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| Biliary cells |
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| Non-Epithelial | Mesenchymal |
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Classification based on consistency
- Based on the consitency of the mass, liver mass can be classified into 2 types:
- Solid
- Cystic
- Complex cysts
- Solid cysts
| Liver mass | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cystic | Solid | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Thin walled | Thick walled Septations | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Single | Multiple | Cystadenoma | Cyst adenocarcinoma | Choledochal cyst | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Simple Hepatic cyst | Polycystic Liver Disease | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Mergo PJ, Ros PR. Benign Lesions of the Liver. In: The Radiologic Clinics of North America, 2, W.B. Saunders, Philadelphia 1998. Vol 36, p.319.
- ↑ Kim TK, Lee E, Jang HJ (2015). "Imaging findings of mimickers of hepatocellular carcinoma". Clin Mol Hepatol. 21 (4): 326–43. doi:10.3350/cmh.2015.21.4.326. PMC 4712159. PMID 26770920.
- ↑ Ferrell, Linda (2000). "Liver Pathology: Cirrhosis, Hepatitis and Primary Liver Tumors. Update and Diagnostic Problems". Modern Pathology. 13 (6): 679–704. doi:10.1038/modpathol.3880119. ISSN 0893-3952.
- ↑ Kim, Tae Kyoung; Lee, Eunchae; Jang, Hyun-Jung (2015). "Imaging findings of mimickers of hepatocellular carcinoma". Clinical and Molecular Hepatology. 21 (4): 326. doi:10.3350/cmh.2015.21.4.326. ISSN 2287-2728.
- ↑ Doo, Kyung Won; Lee, Chang Hee; Choi, Jae Woong; Lee, Jongmee; Kim, Kyeong Ah; Park, Cheol Min (2009). ""Pseudo Washout" Sign in High-Flow Hepatic Hemangioma on Gadoxetic Acid Contrast-Enhanced MRI Mimicking Hypervascular Tumor". American Journal of Roentgenology. 193 (6): W490–W496. doi:10.2214/AJR.08.1732. ISSN 0361-803X.
- ↑ Zech CJ, Herrmann KA, Reiser MF, Schoenberg SO (2007). "MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent Gd-EOB-DTPA". Magn Reson Med Sci. 6 (1): 43–52. PMID 17510541.
- ↑ Cheng, H C; Tsai, S H; Chiang, J H; Chang, C Y (1995). "Hyalinized liver hemangioma mimicking malignant tumor at MR imaging". American Journal of Roentgenology. 165 (4): 1016–1017. doi:10.2214/ajr.165.4.7676959. ISSN 0361-803X.
- ↑ Haratake J, Horie A, Nagafuchi Y (1992). "Hyalinized hemangioma of the liver". Am. J. Gastroenterol. 87 (2): 234–6. PMID 1370873.
- ↑ Takayasu, K; Moriyama, N; Shima, Y; Muramatsu, Y; Yamada, T; Makuuchi, M; Yamasaki, S; Hirohashi, S (1986). "Atypical radiographic findings in hepatic cavernous hemangioma: correlation with histologic features". American Journal of Roentgenology. 146 (6): 1149–1153. doi:10.2214/ajr.146.6.1149. ISSN 0361-803X.
- ↑ Yamashita Y, Shimada M, Taguchi K, Gion T, Hasegawa H, Utsunomiya T, Hamatsu T, Matsumata T, Sugimachi K (2000). "Hepatic sclerosing hemangioma mimicking a metastatic liver tumor: report of a case". Surg. Today. 30 (9): 849–52. PMID 11039718.
- ↑ Kim, Tae Kyoung; Lee, Eunchae; Jang, Hyun-Jung (2015). "Imaging findings of mimickers of hepatocellular carcinoma". Clinical and Molecular Hepatology. 21 (4): 326. doi:10.3350/cmh.2015.21.4.326. ISSN 2287-2728.