Case 100:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

76 year old man with cirrhosis due to hepatitis B.

CT: "Nodule in nodule" sign

Imaging Findings:

Advanced HBV cirrhosis. Note ring enhancing mass (HCC) within a larger non enhancing nodule (likely a dysplastic nodule) in the left obe, causing the nodule-in-nodule sign. In this case the malignant nodule (HCC) demonstrates a ring like rather than solid enhancement, with central necrosis, and wash out of the hypervascular ring component on equilibrium phase, representing malignancy. Note mass effect of mass on left portal vein.