Case 267:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

67 year old man with HBV.

MR: Fat containing, hypovascular, well-differentiated

Imaging Findings:

MR with contrast shows a subcapsular fat containing HCC in segment 6/7 posterior to the right portal vein.  T1w in-phase image shows a well defined hyperintense lesion, with signal drop on the opposed-phase image, indicating intracytoplasmic fat components.  Lesion is hypointense in the T2w fat saturated image.  Upon administration of contrast, it is isointense to liver parenchyma on the arterial sequence, and hypointense to liver in portal venous and equilibrium phase. Biopsy showed well-differentiated type HCC.

The patient had multiple fatty masses, all likely fatty HCCs (not shown here).

Cirrhotic liver is mildly fatty.