Liver mass classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Liver mass}} | {{Liver mass}} | ||
{{CMG}}{{AE}}{{MV}} | {{CMG}}; {{AE}}{{MV}} {{ADG}} | ||
==Overview== | ==Overview== | ||
A liver mass may be | 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== | ==Classification== | ||
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{{familytree/end}} | {{familytree/end}} | ||
=== | ===CLassification based on the number of nodules=== | ||
* Liver mass based on the number of nodules on imaging can be classified into 2 types: | * Liver mass based on the number of nodules on imaging can be classified into 2 types: | ||
** Solitary nodule | ** Solitary nodule | ||
| Line 25: | Line 25: | ||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | | | | | A01 | | | | | | | | |A01=Solid liver mass}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | {{familytree | | | | | | | | | | |,|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| |}} | ||
{{familytree | {{familytree | | | | | | | | | | B01 | | | | | | | | | | | | | | B02 | | | | | |B01=No history of liver disease|B02=History of liver disease|}} | ||
{{familytree | {{familytree | | | | | | | | | | |!| | | | | | | | | | | | | | | |!| | |}} | ||
{{familytree | {{familytree | | | | | |,|-|-|-|-|^|-|-|-|-|-|.| | | | | |,|-|-|-|+|-|-|-|.}} | ||
{{familytree | {{familytree | | | | | C01 | | | | | | | | | C02 | | | | C03 | | C04 | | C05 |C01=Asymptomatic|C02=Symptomatic|C03=Arterial enchancement with washout|C04=Only arterial enchancement|C05=Persistant arterial enhancement|}} | ||
{{familytree | {{familytree | | | | | |!| | | | | | | | | | |!| | | | | |!| | | |!| | | |!|}} | ||
{{familytree | |, | {{familytree | |,|-|-|-|+|-|-|-|.| | | | | | D01 | | | | D02 | | D03 | | D04 |D01=Weight loss|D02=HCC|D03=Dyspatic nodule|D04=Cholangiocarcinoma|}} | ||
{{familytree | E01 | {{familytree | E01 | | E02 | | E03 | | | | | |!| | | | | | | | |E01=Adenoma|E02=FNH*|E03=Hemangioma|}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | |,|-|-|^|-|-|.| |}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | F01 | | | | F02 | |F01=Metastasis<br>H/O of cancer|F02=Fibrolammellar HCC<br> No H/O of cancer}} | ||
{{familytree/end}} | {{familytree/end}} | ||
<small> | <small> | ||
| Line 43: | Line 43: | ||
</small> | </small> | ||
===Classification based on histopathology=== | |||
* Based on the type of histopathology, liver mass can be classified into 2 types: | |||
* Based on the type of | |||
** Benign | ** Benign | ||
** Malignant | ** Malignant | ||
{| | <center> | ||
{| | |||
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |WHO Classification of Liver Tumors | |||
|- | |- | ||
! colspan="3" style="background:# | ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Benign Tumors | ||
! style="background:# | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Malignant Tumors | ||
|- | |- | ||
! rowspan="2" ! align="center" style="background:#DCDCDC;" + |Epithelial | |||
| | ! align="center" style="background:#DCDCDC;" + |Hepatocytes | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*[[Focal nodular hyperplasia]] | *[[Focal nodular hyperplasia]] | ||
*[[Hepatocellular adenoma]] | *[[Hepatocellular adenoma]] | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*[[HCC]] | *[[HCC]] | ||
*Fibrolamellar carcinoma | *Fibrolamellar carcinoma | ||
| Line 65: | Line 65: | ||
*[[Carcinosarcoma of the thyroid|Carcinosarcoma]] | *[[Carcinosarcoma of the thyroid|Carcinosarcoma]] | ||
|- | |- | ||
| | ! align="center" style="background:#DCDCDC;" + |Biliary cells | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*Intrahepatic bileduct adenoma | *Intrahepatic bileduct adenoma | ||
*Intrahepatic bileduct cystadenoma | *Intrahepatic bileduct cystadenoma | ||
*Biliary papillomatosis | *Biliary papillomatosis | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*[[Cystadenocarcinoma]] | *[[Cystadenocarcinoma]] | ||
*[[Cholangiocarcinoma]] | *[[Cholangiocarcinoma]] | ||
|- | |- | ||
| | ! align="center" style="background:#DCDCDC;" + |Non-Epithelial | ||
| | ! align="center" style="background:#DCDCDC;" + |Mesenchymal | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*[[Hemangioma]] | *[[Hemangioma]] | ||
*[[Lymphangioma]] | *[[Lymphangioma]] | ||
| Line 82: | Line 82: | ||
*[[Angiomyolipoma]] | *[[Angiomyolipoma]] | ||
*[[Hemangioma|Infantile Hemangioma]] | *[[Hemangioma|Infantile Hemangioma]] | ||
| | | align="left" style="background:#F5F5F5;" + | | ||
*[[Hemangioendothelioma]] | *[[Hemangioendothelioma]] | ||
*Primary lymphoma | *Primary lymphoma | ||
| Line 88: | Line 88: | ||
*[[Epithelioid sarcoma|Epitheloid]] | *[[Epithelioid sarcoma|Epitheloid]] | ||
|} | |} | ||
</center> | |||
* Based on the consitency of the mass, liver mass can be classified into 2 types | ===Classification based on consistency=== | ||
** Complex cysts | * Based on the consitency of the mass, liver mass can be classified into 2 types: | ||
** Solid cysts | ** Solid | ||
** Cystic | |||
*** Complex cysts | |||
*** Solid cysts | |||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | | | A01 | | | | | | | | |A01=Liver mass}} | ||
{{familytree | {{familytree | | | | | | | | | | | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | | | | | | | |, | {{familytree | | | | | | | | | | | |,|-|-|-|-|^|-|-|-|-|.| | | |}} | ||
{{familytree | | | | | | | | | | | B01 | {{familytree | | | | | | | | | | | B01 | | | | | | | | B02 | | | | | |B01=Cystic|B02=Solid|}} | ||
{{familytree | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | {{familytree | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | |}} | ||
{{familytree | | | |, | {{familytree | | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | |}} | ||
{{familytree | | | | {{familytree | | | | C01 | | | | | | | | | | | C02 | | | | | |C01=Thin walled|C02=Thick walled Septations|}} | ||
{{familytree | | | | | {{familytree | | | | |!| | | | | | | | | | | | |!| | |}} | ||
{{familytree | | | {{familytree | |,|-|-|^|-|-|.| | | |,|-|-|-|-|-|+|-|-|-|-|-|.|}} | ||
{{familytree | D01 | | | | D02 | | D03 | | | | D04 | | | | D05 | |D01=Single|D02=Multiple|D03=Cystadenoma|D04=Cyst adenocarcinoma|D05=Choledochal cyst|}} | |||
{{familytree | |!| | | | | |!| }} | |||
{{familytree | E01 | | | | E02 | |E01=Simple Hepatic cyst|E02=Polycystic Liver Disease}} | |||
{{familytree/end}} | {{familytree/end}} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Gastroenterology]] | |||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category: | [[Category:Oncology]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Surgery]] | [[Category:Surgery]] | ||
Latest revision as of 22:31, 29 July 2020
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Liver Mass Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Liver mass classification On the Web |
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American Roentgen Ray Society Images of Liver mass classification |
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Risk calculators and risk factors for Liver mass classification |
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 |
| |
| Biliary cells |
|
||
| Non-Epithelial | Mesenchymal |
| |
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.