Online Journal
IF値: 1.878(2021年)→1.8(2022年)


Journal of Medical Ultrasonics

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2000 - Vol.27

Vol.27 No.05

Case Report(症例報告)

(0791 - 0798)

正常肝に生じ高度の脂肪化を伴った肝細胞癌の2例 一超音波画像における脂肪性腫瘍との鑑別について−

Two Cases of Hepatocellular Carcinoma with Marked Fatty Change in the Normal Liver: Ultrasonographic Differentiation from Lipomatous Tumors

山本 貴嗣1, 竹内 和男1, 長島 夏子1, 本庶 元1, 桜井 則男1, 奥田 近夫1, 松田 正道2, 橋本 雅司2, 渡邊 五朗2, 関 邦彦3

Takatsugu YAMAMOTO1, Kazuo TAKEUCHI1, Natsuko NAGASHIMA1, Hajime HONJO1, Norio SAKURAI1, Chikao OKUDA1, Masamichi MATSUDA2, Masashi HASHIMOTO2, Goro WATANABE2, Kunihiko SEKI3

1虎の門病院消化器科, 2虎の門病院消化器外科, 3虎の門病院病理部

1Department of Gastroenterology, Toranomon Hospital, 2Department of Surgery, Toranomon Hospital, 3Division of Pathology, Toranomon Hospital

キーワード : Hepatocellular carcinoma, Hyperechoic liver tumor, Lipomatous tumor, Ultrasonography

We report two cases of relatively large hepatocellular carcinomas (HCC) with marked fatty metamorphosis, which were difficult to differentiate from lipomatous tumors (LT). Both tumors occurred in the normal livers, and both were vigorously hyperechoic and had posterior acoustic shadows on ultrasonography (US). Because computed tomography, magnetic resonance imaging, and other imaging modalities were incapable of differentiating HCC from LT, the diagnosis had to be based on histologic examination. On retrospective observation of US imaging, however, those tumors were found to have presented evidence specific for HCC; this included, for example, halo or nodule in nodule, which may lead to an accurate preoperative diagnosis. A survey of the literature suggested that such findings were rare in LT. Such US findings as halo and nodule in nodule were thus considered useful in the differential diagnosis of HCC and LT in cases of large hyperechoic liver tumors, and careful observation of US imaging may be important.