The HCC was treated with radiofrequency ablation, and the ablated HCC was confirmed by Gd-EOB-DTPA-enhanced MRI. Histologically, the nodule was diagnosed as well-differentiated HCC characterized by more than two-fold the cellularity of the non-tumorous area, with a high nuclear:cytoplasmic ratio, increased cytoplasmic eosinophilia, fatty change, and slight cell atypia with an irregular thin trabecular pattern ( fig.

Gd-EOB-DTPA-enhanced MRI revealed no hypervascularity in the early phase, but disclosed a defect in the hepatobiliary phase ( fig. Superparamagnetic iron oxide (SPIO)-MRI revealed isointensity in both T1 and T2 sequences. CTA revealed no hypervascularity and CTAP revealed no perfusion defect. Contrast-enhanced US revealed no hypervascularity in the early vascular phase and no defect in the Kupffer phase. Contrast-enhanced CT revealed no hypervascularity in the early phase and no washout in the late phase. US disclosed an 8-mm hyperechoic nodule in segment 6 ( fig. The levels of tumor markers revealed the following: a-fetoprotein 7.1 ng/ml (0-9.9), protein induced by vitamin K absence II 42 mAU/ml (0-40). HCV antibody and HCV RNA were positive, hepatitis B surface antigen and hepatitis B virus DNA were negative, and laboratory data on admission disclosed the following values: platelets 7.2 × 10 4/μl (normal 13.0-36.9), aspartate aminotransferase 26 IU/l (10-40), alanine aminotransferase 20 IU/l (5-40), thymol turbidity 18.5 U/l (0-4), zinc surface turbidity 13.7 U/l (2-12), indocyanine green retention rate at 15 min 7% (0-10), and γ-globulin 23.3% (10.6-20.5). Here, we describe an 8-mm well-differentiated hepatocellular carcinoma (HCC) detected in the hepatobiliary phase (20 min after injection), whereas contrast-enhanced ultrasound (US) and computed tomography (CT) did not reveal hypervascularity in the early phase and washout in the late phase also, CT during arteriography (CTA) and CT during arterial portography (CTAP) did not reveal hypervascularity and perfusion defect, respectively.Ī 74-year-old woman with hepatitis C virus (HCV)-related cirrhosis was admitted to Kobe Asahi Hospital in April 2008 for further examination of an 8-mm hyperechoic nodule in segment 6. On the other hand, tumors appear like hypointense lesions because they lack normally functioning hepatocytes. Moreover, it begins to accumulate in normally functioning hepatocytes in the hepatobiliary phase 20 min after injection, thereby enhancing the liver parenchyma. A bolus injection of Gd-EOB-DTPA allows the evaluation of tumor vascularity in a manner similar to evaluation with gadolinium-triamine pentaacetic acid (Gd-DTPA). Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a new liver-specific contrast agent used in magnetic resonance imaging (MRI). Our case demonstrates the utility of Gd-EOB-DTPA-enhanced MRI in the diagnosis of small HCC. Histologically, the nodule was diagnosed as well-differentiated HCC characterized by more than two-fold the cellularity of the non-tumorous area, with a high nuclear:cytoplasmic ratio, increased cytoplasmic eosinophilia, fatty change, and slight cell atypia with an irregular thin trabecular pattern. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) revealed no hypervascularity in the early phase, but disclosed a defect in the hepatobiliary phase.

CT during arteriography revealed no hypervascularity and CT during arterial portography disclosed no perfusion defect. Contrast-enhanced computed tomography (CT) and US revealed no hypervascularity in the early phase and no washout in the late phase and the Kupffer phase, respectively. Ultrasound (US) revealed an 8-mm hyperechoic nodule in segment 6 of the liver. We describe an 8-mm hepatocellular carcinoma (HCC) with hepatitis C virus-related cirrhosis in a 74-year-old woman.

Katsumi imoto