HISTORY: 76-year-old male with right flank pain.
FINDINGS: Images 1-3 are transverse scans of the caudal margin of the
right lobe of the liver demonstrating a 4 cm echogenic mass with a
peripheral hypoechoic halo (arrow, Image 1). Ultrasound was used for
percutaneous fine-needle aspiration biopsy of the mass which revealed
hepatocellular carcinoma.
DIAGNOSIS: Hepatocellular carcinoma.
DISCUSSION: Peripheral halos around a hepatic lesion are not typical for
most benign entities such as cysts, hemangiomas, or abscesses. They are
far more likely to be related to metastasis or hepatocellular carcinoma.
The imaging features are non-specific and biopsy is often required for a
precise diagnosis. A metastatic lesion could have a similar sonographic
appearance to this hepatocellular carcinoma. Color Doppler imaging
typically demonstrates intralesional flow with hepatocellular carcinoma
and peripheral flow with metastases.
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