Radiological and histopathological correlation of hepatic tumors in computed tomography and magnetic resonance imaging
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252014Keywords:
Hepatic tumors, CT, MRI, Angiomyolipoma, Radiopathological correlationAbstract
Background: Hepatic tumors present a diagnostic challenge due to overlapping radiological features with both benign and malignant lesions. Differentiating these tumors accurately is essential for appropriate management. Correlating imaging findings with histopathology can enhance diagnostic confidence and reduce unnecessary interventions.
Methods: A prospective study was conducted at SCB Medical College, Cuttack, from January 2021 to December 2022, involving 100 patients with hepatic tumors. All patients underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) followed by histopathological evaluation. Radiological findings were compared with histopathology and immunohistochemistry for diagnostic correlation.
Results: Out of 100 hepatic tumor cases, 58% showed hypervascularity and 82% had well-defined margins on imaging. T2 hyperintensity was observed in 77% and T1 hypointensity in 60% of lesions. Fat was detected radiologically and histologically in 40% of cases. Histopathology confirmed hepatocellular carcinoma in 45%, angiomyolipoma (AML) in 12%, and other benign tumors in the rest.
Conclusions: Radiological features alone may be insufficient for definitive diagnosis. Correlation with histopathology is essential, especially in fat-deficient lesions.
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References
Mergo PJ, Ros PR. Benign lesions of the liver. Radiol Clin North Am. 1998;36:319-31. DOI: https://doi.org/10.1016/S0033-8389(05)70025-7
Ahmadi T, Itai Y, Takahashi M, Onaya H, Kobayashi T, Tanaka YO, et al. Angiomyolipoma of the liver: significance of CT and MR dynamic study. Abdom Imaging. 1998;23:520-6. DOI: https://doi.org/10.1007/s002619900391
Nanomura A, Mizukami Y, Kadoya M. Angiomyolipoma of the liver: a collective review. J Gastroenterol. 1994;29:95-105. DOI: https://doi.org/10.1007/BF01229084
Tsui WM, Colombari R, Portmann BC, Bonetti F, Thung SN, Ferrell LD, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999;23:34-48. DOI: https://doi.org/10.1097/00000478-199901000-00004
Nonomura A, Minato H, Kurumaya H. Angiomyolipoma predominantly composed of smooth muscle cells: problems in histological diagnosis. Histopathology. 1998;33:20-7. DOI: https://doi.org/10.1046/j.1365-2559.1998.00426.x
Wang LX, Liu K, Lin GW, Jiang T. Primary hepatic neuroendocrine tumors: comparing CT and MRI features with pathology. Cancer Imaging. 2015;15:1-7. DOI: https://doi.org/10.1186/s40644-015-0046-0
Tan Y, Xiao EH. Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature. Abdominal Imaging. 2013;38:511-26. DOI: https://doi.org/10.1007/s00261-012-9918-y
Guidi G, Catalano O, Rotondo A. Spontaneous rupture of a hepatic angiomyolipoma: CT findings and literature review. Eur Radiol. 1997;7:335-7. DOI: https://doi.org/10.1007/s003300050162
Sola JE, Pierre-Jerome F, Sitzmann JV, Wheeler J, Bizzi A, Terotola SO. Multifocal angiomyolipoma in a patient with tuberous sclerosis. Clin Imaging. 1996;20:99-102. DOI: https://doi.org/10.1016/0899-7071(94)00080-8
Sakamoto Y, Inoue K, Ohtomo K, Mori M, Makuuchi M. Magnetic resonance imaging of an angiomyolipoma of the liver. Abdom Imaging. 1998;23:158-60. DOI: https://doi.org/10.1007/s002619900311
Arslan A, Ciftci E, Cetin A, Selcuk H, Demirci A. Tuberous sclerosis: ultrasound, CT and MRI features of two cases with multiple organ involvement. Australas Radiol. 1998;42:379-82. DOI: https://doi.org/10.1111/j.1440-1673.1998.tb00544.x
Irie H, Honda H, Kuroiwa T, Yoshimitsu K, Tajima T, Jimi M, et al. Hepatic angiomyolipoma: report of changing size and internal composition on follow-up examination in two cases. J Comput Assist Tomogr. 1999;23:310-3. DOI: https://doi.org/10.1097/00004728-199903000-00025
Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK. CT and MR imaging of benign hepatic and biliary tumors. Radiographics. 1999;19:431-51. DOI: https://doi.org/10.1148/radiographics.19.2.g99mr04431
Cheung YC, Ng SH, Tan CF, Wong HF, Wan YL. Lymphangiectasia within angiomyolipoma in a tuberous sclerosis patient. Clin Imaging. 1999;23:242-4. DOI: https://doi.org/10.1016/S0899-7071(99)00139-4
Flemming P, Lehmann U, Becker T, Klempnauer J, Kreipe H. Common and epithelioid variants of hepatic angiomyolipoma (AML) exhibit clonal growth and share a distinctive immunophenotype. Hepatology. 2000;32:213-7. DOI: https://doi.org/10.1053/jhep.2000.9142
Fetsch PA, Fetsch JF, Marincola FM, Travis W, Batts KP, Abati A. Comparison of melanoma antigen recognized by T cells (MART-1) to HMB-45: additional evidence to support a common lineage for angiomyolipoma, lymphangiomyomatosis, and clear cell sugar tumor. Mod Pathol. 1998;11:699-703.
Dalle I, Sciot R, de Vos R, Aerts R, van Damme B, Desmet V, Roskams T. Malignant angiomyolipoma of the liver: a hitherto unreported variant. Histopathology. 2000;36:443-50. DOI: https://doi.org/10.1046/j.1365-2559.2000.00891.x
Goodman ZD, Ishak KG. Angiomyolipomas of the liver. Am J Surg Pathol. 1984;8:745-50. DOI: https://doi.org/10.1097/00000478-198410000-00003
Nonomura A, Mizukami Y, Kadoya M, Takayanagi N, Hirono T. Multiple angiomyolipoma of the liver. J Clin Gastroenterol. 1995;20:248-51. DOI: https://doi.org/10.1097/00004836-199504000-00018
Kyokane T, Akita Y, Katayama M, Sato T, Shichino S, Nimura Y. Multiple angiomyolipomas of the liver. Hepatogastroenterology. 1995;42:510-5.
Carmody E, Yeung E, McLoughlin M. Angiomyolipomas of the liver in tuberous sclerosis. Abdom Imaging. 1994;19:537-9. DOI: https://doi.org/10.1007/BF00198257
Jinzaki M, Ohkuma K, Tanimoto A, Mukai M, Hiramatsu K, Murai M, et al. Small solid renal lesions: usefulness of power Doppler US. Radiology. 1998;209:543-50. DOI: https://doi.org/10.1148/radiology.209.2.9807587
Barzilai IM, Braden GL, Ford LD, Goodman LH, Delima RJ, Germain MJ, et al. Renal angiomyolipoma with arteriovenous shunting. J Urol. 1987;137:483-4. DOI: https://doi.org/10.1016/S0022-5347(17)44078-X
Danneels F, Meeus L, Casselman JW, Pattyn G, Vandvoorde P, Steyaert L, et al. Giant angiomyolipoma with atypical arteriovenous shunting: CT and angiographic studies. J Belge Radiol. 1990;73:135-7.
Kehagias D, Mourikis D, Manolakos K, Vlahos L. Arteriovenous shunting in a giant renal angiomyolipoma. A rare condition. Int Urol Nephrol. 1999;31:291-3. DOI: https://doi.org/10.1023/A:1007157632086
Bergeron P, Oliva VL, Lalonde L, Allaire G, Dery R, Bui BT, et al. Liver angiomyolipoma: classic and unusual presentation. Abdom Imaging. 1994;19:543-5. DOI: https://doi.org/10.1007/BF00198259
Högemann D, Köstler H, Baus S, Mössinger M, Weimann A, Galanski M. Diagnostik der FNH mit hepatobiliärem MR-Kontrastmittel (MnDPDP). Rofo. 1999;170:114.
Coffin CM, Diche T, Mahfouz A, Alexandre M, Caseiro-Alves F, Rahmouni A, et al. Benign and malignant hepatocellular tumors: evaluation of tumoral enhancement after mangafodipir trisodium injection on MR imaging. Eur Radiol. 1999;9:444-9. DOI: https://doi.org/10.1007/s003300050689
Murakami T, Baron RL, Peterson MS, Oliver JH III, Davis PL, Confer SR, et al. Hepatocellular carcinoma: MR imaging with mangafodipir trisodium (MnDPDP). Radiology. 1996;200:69-77. DOI: https://doi.org/10.1148/radiology.200.1.8657947
Ni Y, Marchal G, Zhang X, Van Hecke P, Michiels J, Yu J, et al. The uptake of manganese dipyridoxal-diphosphate by chemically induced hepatocellular carcinoma in rats. A correlation between contrast-media-enhanced magnetic resonance imaging, tumor differentiation, and vascularization. Invest Radiol. 1993;28:520-8. DOI: https://doi.org/10.1097/00004424-199306000-00011
Hooper LD, Mergo PJ, Ros PR. Multiple hepatorenal angiomyolipomas: diagnosis with fat suppression, gadolinium-enhanced MRI. Abdom Imaging. 1994;19:549-51. DOI: https://doi.org/10.1007/BF00198261
Martin J, Puig J, Falco J, Donoso L, Rue M, Sentis M, et al. Hyperechoic liver nodules: characterization with proton fat-water chemical shift MR imaging. Radiology. 1998;207:325-30. DOI: https://doi.org/10.1148/radiology.207.2.9577476
Yoshikawa J, Matsui O, Takashima T, Ida M, Takanaka T, Kawamura I, et al. Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR. 1988;151:717-20. DOI: https://doi.org/10.2214/ajr.151.4.717
Kapur RP, Bigler SA, Skelly M, Gown AM. Anti-melanoma monoclonal antibody HMB-45 identifies an oncofetal glycoconjugate associated with immature melanosomes. J Histochem Cytochem. 1992;40:207-12. DOI: https://doi.org/10.1177/40.2.1552165
Ruck P, Kaiserlink E. Melanin-containing hepatoblastoma with endocrine differentiation: an immunohistochemical and ultrastructural study. Cancer. 1993;72:361-8. DOI: https://doi.org/10.1002/1097-0142(19930715)72:2<361::AID-CNCR2820720209>3.0.CO;2-3