HEPATIC METASTATIC LESIONS

Click icon to add picture

DR. CHIRANJIB MURMUMD RADIOLOGY

2

• 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

3

• Sensitivity of lesion: MR>CECT>FDG PET CT

4

ON US

Echogenic mets: GI Malignancy HCCHypoechoic mets:Most mets are hypoechoicLymphomabull’s eye

5

• Mucinous mets: colon, thyroid, ovary, kidney, stomach.

• Cystic mets: mucinous mets, Ca pancreas, necrotic leiomyosarcomas.

6

ON CECT- vascularity

• Hypovascular• Hypervascular (RCC/Breast ca/islet cell)• Rim enhancing/cystic• Hemorrhagic

7

Size

• Small lesions are nodular, homogenous.• Large lesions are irregular, heterogenous.

8

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.

9

Undifferentiated sarcoma

• Large solitary lesion, enhancing solid components

10

Biliary cystadenocarcinoma

• Multilocular , mural nodules, fibrous capsule, calcification, variable signal on MR.

11

Cystic mets

• Multiple/multiloculated, peripheral rim enhancement, septations.

12

Lymphoma

• Primary hepatic lymphoma rare (solitary, hypodence, poorly enhancing,

• Often NHL/AIDS/ Organ transplant recipient.

13

Secondary lymphoma

• More common than primary.• HL (diffuse involvement)• NHL(diffuse +nodular involvement)• Poorly enhancing.• Imaging very non-specific• Spleen-hypodence lesion• LN

14

THANK YOU