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HEPATIC METASTATIC LESIONS
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DR. CHIRANJIB MURMUMD RADIOLOGY
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• 30% of patients who die of malignancy have liver metastases.
• 90% in right lobe• Most are from: -colorectal ca - stomach ca - pancreatic ca - breast/lung ca
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• Sensitivity of lesion: MR>CECT>FDG PET CT
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ON US
Echogenic mets: GI Malignancy HCCHypoechoic mets:Most mets are hypoechoicLymphomabull’s eye
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• Mucinous mets: colon, thyroid, ovary, kidney, stomach.
• Cystic mets: mucinous mets, Ca pancreas, necrotic leiomyosarcomas.
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ON CECT- vascularity
• Hypovascular• Hypervascular (RCC/Breast ca/islet cell)• Rim enhancing/cystic• Hemorrhagic
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Size
• Small lesions are nodular, homogenous.• Large lesions are irregular, heterogenous.
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Calcification
• If calcification, it is either GI malignancy(colorectal ca) or treated carcinoid, neuroblastoma, mesothalioma, bronchogenic ca, melanoma, osteosarcoma, thyroid ca, RCC/Breast ca, testicular ca.
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Undifferentiated sarcoma
• Large solitary lesion, enhancing solid components
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Biliary cystadenocarcinoma
• Multilocular , mural nodules, fibrous capsule, calcification, variable signal on MR.
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Cystic mets
• Multiple/multiloculated, peripheral rim enhancement, septations.
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Lymphoma
• Primary hepatic lymphoma rare (solitary, hypodence, poorly enhancing,
• Often NHL/AIDS/ Organ transplant recipient.
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Secondary lymphoma
• More common than primary.• HL (diffuse involvement)• NHL(diffuse +nodular involvement)• Poorly enhancing.• Imaging very non-specific• Spleen-hypodence lesion• LN
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THANK YOU