Uncommon malignant hepatocellular tumor • Also known as fibrolamellar hepatocellular carcinoma (HCC) Distinct clinical, histopathologic, and imaging features differentiate it from conventional HCC IMAGING • Heterogeneously enhancing, large, lobulated mass with hypointense…
Sonographic McBurney sign with focal pain over appendix Shadowing, echogenic appendicolith Increased flow within wall of appendix, indicating inflammation Increased echogenicity of inflamed periappendiceal fat • CT: Abnormal mural enhancement of…
Air-fluid levels on upright or decubitus radiograph • Transition zone between dilated and collapsed bowel is critical to define presence, site, and cause of obstruction All better determined on CT than…
MR: FLASH sequences Gadolinium enhancement required to detect very small lesions TOP DIFFERENTIAL DIAGNOSES • Metastases • Lymphomatous/leukemic foci in liver • Biliary hamartomas • Caroli disease PATHOLOGY • Originates from intestinal seeding of portal…
Extremely aggressive and almost always unresectable Large, heterogeneous, moderately enhancing, exophytic mass with necrosis and cystic change • Small cell carcinoma Highly aggressive, with hematologic and lymphatic metastases at time of…
Become isodense (isointense) on venous and delayed phases • Pseudolesions on nuclear medicine studies e.g., “hot” accumulation of Tc-sulfur colloid in left lobe of liver in patients with SVC obstruction “Hot”…
Often lobar, segmental, or wedge shaped Along hepatic vessels, ligaments, and fissures Presence of normal vessels coursing through “lesion” (fatty infiltration) • NECT: Liver attenuation < spleen • US: ↑ echogenicity, ↑…
Deformity of bulb (edema and spasm and scarring) Pseudodiverticula balloon-out between areas of fibrosis and spasm “Cloverleaf” deformity of bulb due to pseudodiverticula • CT with IV and oral contrast medium…
Diagnosis best made on portal venous phase images due to heterogeneous arterial phase enhancement Global infarction: Complete nonenhancement of spleen – ± cortical rim sign: Preserved enhancement of peripheral rim of…
Transthoracic esophagectomy: Usually performed through right intercostal approach (Ivor Lewis procedure) Other options include minimally invasive (laparoscopic) procedures • Stomach is ideal conduit, as it has reliable blood supply and can…
