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A Case of the Week

Case 20

 An eighty one-year-old male was introduced to our hospital from a local hospital because of the presence of a liver occupying lesion on CT but hard detection on abdominal ultrasound. He was informed to be a carrier of hepatitis B virus infection.
 Laboratory test : White blood cells 3970/ mm3 Monocytes 15.6%, Total bilirubin 2.30 mg/dl (0.22-1.20), AST 96 U/l, ALT 16 U/l, LDH 2170 U/L, ALP 213U/L, HBs antigen 6.27 IU/ml, HCV antibody negative, 0.03 S/CO, PIVKA-II 60 mA/ml, AFP 5.4 ng/ml, CRP 3.67mg/dl, IL-2 4960U/ml
 The patient received EOB-enhanced MRI (Figs 1, 2, 3), and contrast-enhanced CT(Fig.4), pelvis CT, and endoscopy of upper and lower gastrointestinal tract were performed. No abnormal findings were found without a liver space occupying lesion.

What is the appropriate imaging diagnosis ?

1. Hepatocellular carcinoma

2. Cholangiocellular carcinoma

3. Inflammatory pseudotumor

4. Malignant lymphoma

5. Metastatic liver tumor


2016.8.24



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