Hepatocarcinoma fibrolamelar un tumor de adultos jóvenes poco frecuente. . Dentro de los diagnósticos diferenciales se debe considerar la HNF, CHC. Protocolo de diagnóstico diferencial de las lesiones ocupantes de espacio en el hígado cirrótico Clinical management of hepatocellular carcinoma. Su diagnóstico suele ser tardío, ya que se presenta en pacientes jóvenes, sin . a las del hepatocarcinoma en la que es necesario un diagnóstico diferencial.

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Fibrolamellar hepatocellular carcinoma presenting with Budd-Chiari syndrome, right atrial thrombus, and pulmonary emboli.

HEPATOCARCINOMA DE CÈLULAS CLARAS by marta garnica ureña on Prezi

Radiology ; 2: Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: However, MRI does not allow for the diagnosis in all cases whose etiology remains undetermined. Computed tomography of body with magnetic resonance imaging.

Belo Horizonte, MG, Contrast uptake is also observed in focal liver lesions with functioning hepatocytes 1. At conventional MRI, hemangiomas present marked hypersignal on T2-weighted, hyposignal on T1-weighted sequences, discontinuous, nodular, peripheral contrast enhancement in the arterial phase, tending to centripetal fill-in by the contrast agent in the subsequent phases 13 The usual dynamic study with arterial, portal and delayed phases is also performed with such contrast agents.

Prevalence of simple liver cysts and hemangiomas in cirrhotic and non-cirrhotic patients submitted to magnetic resonance imaging.

As the gadoxetic acid dose corresponds to one quarter of the habitual extracellular gadolinium dose, the idferencial phase acquisition time is critical, requiring temporal precision methods, such as real time visualization of the contrast progression through the arterial system, for the success in this phase acquisition. Caroli’s disease complicated with liver abscess: In cirrhosis, the hepatobiliary contrast uptake by the nodules depends on their differentiation stage and on the presence of functioning hepatocytes.

Fibrolamellar variant of hepatocellular carcinoma. As necessary, heavily T2-weighted cholangiographic images should also hepatocarcnoma acquired before the contrast injection, since hepatobiliary contrast agents are excreted by the biliary tract and can shorten the T2-relaxation time. Author information Article notes Copyright and License information Disclaimer.


Female, year-old patient with liver nodules to be clarified. However, the differentiation between FNH and adenoma is not always easy at conventional MRI, because both conditions may appear as nonspecific hypervascular lesions, generating anguish for the patient and challenging the physician, in addition to the cost and patient’s anxiety with repeated examinations. Computed body tomography with MRI correlation.

We report a case of diagnostkco patient admitted at Hospital Mater Dei in Belo Horizonte, MG, Brazil, due to fibrolamellar hepatocarcinoma, and discuss the clinical, radiological and pathological features of this disease.

Such a lesion shows intense and homogeneous contrast uptake in the arterial-phase, with decay in the portal and delayed phases, presenting greater hepatobiliary contrast uptake than the adjacent parenchyma, suggesting FNH as the first diagnostic hypothesis. Diffusion- and T2-weighted sequences may be acquired after hepatobiliary contrast agent injection, considering that there is no significant interference effect.

MR Imaging of hepatocellular carcinoma in the cirrhotic liver: Hepatobiliary contrast allows for the differentiation between biliary lesions and extrabiliary cysts, since it delineates the biliary tract, demonstrating the communication of biliary cystic lesions with the bile ducts, and extrabiliary cystic lesions that do not communicate with bile ducts, such as pseudocysts, duodenal diverticula and duodenal duplication cysts 5.

Cancer ; 46 2: Although containing functioning hepatocytes, there is a lack of biliary ducts resulting in deficiency in bilirubin and hepatobiliary contrast excretion. Phase II trial of systemic continuous fluorouracil and subcutaneous recombinant interferon Alfa-2b for treatment of hepatocellular carcinoma. Further potential hepatobiliary contrast applications include evaluation of the functional hepatic reserve before partial hepatectomy; evaluation of live donor’s hepatic function as well as evaluation of early liver failure after transplant.

Rio de Janeiro, RJ, Brazil, Magnetic resonance imaging is considered the best imaging method for evaluating such lesions, but does not allow for the diagnosis in all cases. Eur J Cancer ; 49 Additionally, hepatobiliary contrast agents contribute to the diagnosis of small, benign focal lesions frequently found in patients with neoplasias, particularly FNH Figure 8. In cirrhosis, hepatocytes are progressively replaced by fibrotic tissue, so that the more advanced the fibrosis, the smaller the hepatic parenchyma enhancement in the hepatobiliary phase.


The imaging characterization of benign and malignant liver lesions is very important. Hemangiomas normally have a typical presentation at MRI with extracellular contrast and are not an indication for investigation with hepatobiliary contrast. Distinguishing hypervascular pseudolesions of the liver from hypervascular hepatocellular carcinomas with gadoxetic acid-enhanced MR imaging.

Patients with advanced liver and kidney diseases alternatively compensate the contrast agents clearance by renal or biliary excretion, respectively. Further potential hepatobiliary contrast applications include the evaluation of the functional hepatic reserve before partial hepatectomy; evaluation of live donor’s hepatic function as well as evaluation of early liver failure after transplant 4.

Accuracy of ultrasonography, spiral CT, magnetic resonance and alpha-fetoprotein in diagnosing hepatocellular carcinoma: The conclusions reinforce the importance of radiological imaging for the detection and characterization of hepatic focal neoplasms.

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Several studies are evaluating the relation between the degree of hepatic fibrosis in patients with cirrhosis As well as the hepatobiliary contrast enhancement with the objective of reducing the necessity of biopsies currently considered a gold standard. The caudate lobe lesion arrowheads presents subtle hypersignal on T2-weighted sequence and signal loss on T1-weighted out-of-phase sequence caused by the presence of intralesional fat.

The hepatobiliary phase may also be useful in the post-chemoembolization or post-radiofrequency ablation follow-up, considering that inflammatory reactions show hepatobiliary contrast uptake and residual HCC tends to not present contrast uptake New proposal for the staging of nonalcoholic steatohepatitis: Is fibrolamellar carcinoma different from hepatocellular carcinoma?

FNH is a benign lesion that does not require any intervention, while adenoma presents risk for malignization, necrosis and bleeding which might require emergency surgery.