Open AccessFocal liver lesions found incidentally
Author(s) -
Abdulrahman D Algarni,
Abdullah H Alshuhri,
Majed M Alonazi,
Moustafa Mabrouk Mourad,
Simon R. Bramhall
Publication year - 2016
Publication title -
world journal of hepatology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v8.i9.446
Subject(s) - medicine , cirrhosis , focal nodular hyperplasia , radiology , liver biopsy , differential diagnosis , gold standard (test) , magnetic resonance imaging , liver function tests , liver disease , ultrasound , biopsy , surgery , hepatocellular carcinoma , pathology
Incidentally found focal liver lesions are a common finding and a reason for referral to hepatobiliary service. They are often discovered in patients with history of liver cirrhosis, colorectal cancer, incidentally during work up for abdominal pain or in a trauma setting. Specific points should considered during history taking such as risk factors of liver cirrhosis; hepatitis, alcohol consumption, substance exposure or use of oral contraceptive pills and metabolic syndromes. Full blood count, liver function test and tumor markers can act as a guide to minimize the differential diagnosis and to categorize the degree of liver disease. Imaging should start with B-mode ultrasound. If available, contrast enhanced ultrasound is a feasible, safe, cost effective option and increases the ability to reach a diagnosis. Contrast enhanced computed tomography should be considered next. It is more accurate in diagnosis and better to study anatomy for possible operation. Contrast enhanced magnetic resonance is the gold standard with the highest sensitivity. If doubt still remains, the options are biopsy or surgical excision.