case_images: PMC6217880_01
case_images: Computed tomography (CT) findings: plain CT scan performed at the diagnosis of cancer showed no hepatic abnormality.
case_images: CRIHEP2018-5409316.001.jpg
case_images: PMC6217880_01_CRIHEP2018-5409316.001.jpg
case_images: fig1
case_images: Computed tomography (CT) scan performed at the diagnosis of cancer and ultrasonography test before each cycle of chemotherapy showed no hepatic abnormality (Figure 1).
case_images: Abdominal ultrasonography (USG) and CT findings: (a) USG shows a 3 x 3cm slightly hypoisoechoic hepatic lesion in left lateral lobe with slightly unclear borders and blood flow signal; (b) plain CT shows that the lesion is lobulated, homogeneous, and isointense compared to surrounding liver parenchyma; (c) enhanced CT shows that hypervascular lesion appears hyperdense with a slightly hypodense central scar in the arterial phase (arrows); (d) in the portal venous phase the lesion is isodense without signs of central scar.
case_images: CRIHEP2018-5409316.002.jpg
case_images: PMC6217880_01_CRIHEP2018-5409316.002.jpg
case_images: fig2
case_images: After 4 courses of chemotherapy, a 3 x 3cm slightly hypoisoechoic hepatic lesion was identified in left lateral lobe on routine ultrasonography (USG) (Figure 2(a)). On subsequent plain CT scan, the lesion is homogeneous and isointense compared to surrounding liver parenchyma (Figure 2(b)). After enhancement, rapid homogeneous enhancement of lobular-shaped nodule was seen in the arterial phase with a slightly hypodense central scar (Figure 2(c)). The lesion is isodense without signs of central scar in the portal venous phase (Figure 2(d)).
case_images: Abdominal magnetic resonance imaging (MRI) findings: (a) T1-weighted image shows that the lesion is slightly hypointense with the central scar appears more significant hypointense (arrow); (b) T2-weighted images shows the same lesion as slightly hyperintense; (c) after enhancement, the signal of the lesion is markedly increased and appears hyperintense during the arterial phase except for the central area in fat-saturated T1-weighted image; (d) in the portal venous phase, the lesion is slightly hyperintense compared to the normal liver tissue and the central scar is poorly recognized.
case_images: CRIHEP2018-5409316.003.jpg
case_images: PMC6217880_01_CRIHEP2018-5409316.003.jpg
case_images: fig3
case_images: Abdominal magnetic resonance imaging (MRI) showed that the lesion is slightly hypointense on T1-weighted image with the central scar appears more significant hypointense (Figure 3(a)) and slightly hyperintense on T2-weighted images (Figure 3(b)). After enhancement, there is strong homogeneous enhancement of the lesion except for the central area during the arterial phase (Figure 3(c)) and slightly hyperintense in the portal venous phase (Figure 3(d)) compared to the normal liver tissue in fat-saturated T1-weighted image.