59-year-old female patient with history of breast cancer



Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Niayesh Keshvari


Case Section

Abdominal Imaging


Patient's Information

Gender : Female
Age : 59


Clinical Summary

59-year-old female patient with history of breast cancer


Imaging Findings

Multiple variable sized hepatic focal lesions that show peripheral noduar enhancement in arterial phase followed by centripetal filling (closed iris sign), the large display incomplete filling in delayed phase due to central necrosis and scar.


Differential Diagnosis

1-hepatic metastases
hypervascular hepatic metastases show marked early enhancement with a continuous ring that on later images fills in centrally and progressive centripetal fill-in may occur on delayed phases
2-hepatocellular carcinoma
3-hepatic cyst
4-hepatic abscess
5-regenerative nodules / dysplastic nodules
6-cystic hepatic or biliary neoplasm


Final Diagnosis

Hepatic haemangioma


Discussion (Related Text)

Hemangioma is the most common benign tumor of the liver. The classic diagnostic findings for hemangioma are as follow : on unenhanced CT, hypoattenuation similar to that of vessels; on dynamic contrast-enhanced CT or MR imaging, peripheral globular enhancement and a centripetal fill-in pattern with the attenuation of enhancing areas identical to that of the aorta and blood pool; on T2- and heavily T2-weighted MR imaging, hyperintensity similar to that of cerebrospinal fluid; on sonography, homogeneous hyperechogenicity or hypo- or isoechogenicity with a hyperechoic rim; and on delayed phases of 99mTc RBC scanning, a defect in the early phases that shows prolonged and persistent filling-in. Because of advances in imaging technology, hemangiomas are being detected more frequently.



American Journal of Roentgenology. 2003;180: 135-141.


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