HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Peterson, M. S. Articles by Rankin, S. C. Search for Related Content PubMed PubMed Citation Articles by Peterson, M. S. Articles by Rankin, S. C. Social Bookmarking                      What's this?

Hepatic Angiosarcoma

Findings on Multiphasic Contrast-Enhanced Helical CT Do Not Mimic Hepatic Hemangioma

¹ Department of Radiology, University of Pittsburgh School of Medicine, 200 Lothrop St., Pittsburgh, PA 15213-2582.
² Department of Radiology, Guy's Hospital, St. Thomas St., London SE1 9RT, United Kingdom.

View larger version (121K): [in a new window]   Fig. 1A. —63-year-old man with multifocal angiosarcoma. Unenhanced helical CT scan shows multiple masses (arrows) that are hypoattenuated to liver and hypo- and isoattenuated to vessels.

View larger version (133K): [in a new window]   Fig. 1B. —63-year-old man with multifocal angiosarcoma. Arterial phase contrast-enhanced helical CT scan shows heterogeneous enhancement of tumors (long arrows), most of which are hyperattenuated to normal liver but hypoattenuated to aorta. One lesion (short arrow) is hypoattenuated to both liver and aorta.

View larger version (129K): [in a new window]   Fig. 1C. —63-year-old man with multifocal angiosarcoma. Portal venous phase contrast-enhanced helical CT scan shows that most lesions that were hyperattenuated in B (long arrows) are now nearly isoattenuated to liver, but are hypoattenuated to vessels. Large lesion (short arrow) remains hypoattenuated to both liver and vessels.

View larger version (131K): [in a new window]   Fig. 2A. —54-year-old man with multifocal angiosarcoma. Arterial phase (A) and portal venous phase (B) contrast-enhanced helical CT scans show large infiltrative mass (large straight arrows) involving entire left hepatic lobe, small mass (small straight arrow) in right hepatic lobe, and splenic metastasis (curved arrow). Tumors are hypoattenuated to surrounding liver and aorta. Note masses remain hypoattenuated to surrounding liver and aorta during portal venous phase (B).

View larger version (129K): [in a new window]   Fig. 2B. —54-year-old man with multifocal angiosarcoma. Arterial phase (A) and portal venous phase (B) contrast-enhanced helical CT scans show large infiltrative mass (large straight arrows) involving entire left hepatic lobe, small mass (small straight arrow) in right hepatic lobe, and splenic metastasis (curved arrow). Tumors are hypoattenuated to surrounding liver and aorta. Note masses remain hypoattenuated to surrounding liver and aorta during portal venous phase (B).

View larger version (150K): [in a new window]   Fig. 3A. —65-year-old man with multifocal angiosarcoma and intratumoral hemorrhage. Unenhanced helical CT scan shows multiple low-attenuation liver masses (arrows), hypoattenuated to liver and isoattenuated to aorta. High-attenuation intratumoral hemorrhage in right hepatic lobe mass (straight arrow) was attributed to recent needle biopsy.

View larger version (122K): [in a new window]   Fig. 3B. —65-year-old man with multifocal angiosarcoma and intratumoral hemorrhage. Arterial phase contrast-enhanced helical CT scan shows multiple liver masses (arrows), both hypo- and hyperattenuated to liver. Note single posterior left lobe nodule (open curved arrow) with peripheral nodular enhancement isoattenuated to aorta.

View larger version (141K): [in a new window]   Fig. 3C. —65-year-old man with multifocal angiosarcoma and intratumoral hemorrhage. Portal venous phase contrast-enhanced helical CT scan shows that although most tumor nodules (straight arrow) remain hypoattenuated to liver, one (solid curved arrow) is homogeneously hyperattenuated to liver. Posterior left lobe nodule shows increased peripheral enhancement (open curved arrow) isoattenuated to aorta, mimicking hepatic hemangioma.

View larger version (162K): [in a new window]   Fig. 3D. —65-year-old man with multifocal angiosarcoma and intratumoral hemorrhage. Four-minute delayed contrast-enhanced helical CT scan shows that many liver nodules (solid curved arrow) have become isoattenuated to liver, although some (straight arrow) are hypoattenuated to liver. Posterior left lobe nodule shows increased enhancement (open curved arrow) isoattenuated to aorta, simulating hepatic hemangioma.

View larger version (138K): [in a new window]   Fig. 3E. —65-year-old man with multifocal angiosarcoma and intratumoral hemorrhage. Four-minute delayed contrast-enhanced helical CT scan at more caudal level than D. Note unusual layering effects of contrast-opacified blood and nonopacified blood in tumor nodules (arrows).

View larger version (142K): [in a new window]   Fig. 4A. —64-year-old woman with thorotrast-induced angiosarcoma. Arterial phase contrast-enhanced helical CT scan shows tumor nodules (solid curved arrows) hypoattenuated to both liver and aorta. Accumulation of high-attenuation thorotrast is seen in liver (straight arrows), spleen (arrowhead), and gastrohepatic ligament lymph nodes (open curved arrow).

View larger version (143K): [in a new window]   Fig. 4B. —64-year-old woman with thorotrast-induced angiosarcoma. Portal venous phase contrast-enhanced helical CT scan shows tumor nodules (arrows) remain hypoattenuated to liver and vessels.

View larger version (130K): [in a new window]   Fig. 5. —80-year-old man with multifocal angiosarcoma with intratumoral hemorrhage and hemoperitoneum. Portal venous phase helical CT scan shows fluid-fluid level (curved arrow) from hemorrhage in right hepatic lobe tumor. Note also hemoperitoneum (arrowhead) anterior to left hepatic lobe tumor (straight arrows).

View larger version (127K): [in a new window]   Fig. 6A. —69-year-old man with hemochromatosis and multifocal angiosarcoma diagnosed after liver transplantation. Arterial phase contrast-enhanced helical CT scan shows small tumor nodule (arrow), hyperattenuated to liver but hypoattenuated to aorta.

View larger version (146K): [in a new window]   Fig. 6B. —69-year-old man with hemochromatosis and multifocal angiosarcoma diagnosed after liver transplantation. Portal venous phase contrast-enhanced helical CT scan shows small tumor nodule (arrow) that remains hyperattenuated to liver and isoattenuated to aorta. Note diffusely heterogeneous enhancement of liver parenchyma. Diffuse and multifocal tumor was found at pathologic evaluation of explanted native liver.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati