Case 236:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

67 year old man with chronic hepatitis C infection. Screening ultrasound revealed a lesion in the right hepatic lobe. The lesion demonstrated mild increase in size over one year.

US: With right hepatic vein thrombus

Imaging Findings:

Ultrasound shows biopsy proven nodular bilobed HCC peripherally located in segment 8 with invasion of the right hepatic vein. Pulse Doppler demonstrates arterial flow within the HCC.

Slightly echogenic appearance of the right hepatic vein compared to the accessory vein posteriorly, representing a thrombus. No vascularity detected by Power Doppler within the thrombus. Compare to CT and MR so see enhancement of thrombus.