Synchronous multicentric small hepatocellular carcinomas: defining the capsule on high-frequency intraoperative ultrasonography with pathologic correlation

The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multic...

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Bibliographic Details
Published in:Ultrasonography (Seoul, Korea) 2016, 35(4), , pp.335-344
Main Authors: Ahn, Jae Hong, Eom, Dae-Woon, Ryu, Dae Shick, Park, Man Soo, Jung, Seung Mun, Choi, Kun Moo, Cheon, Gab Jin, Choi, Soo-Jung, Jang, Hyuk Jai
Format: Article
Language:English
Subjects:
Carcinoma, hepatocellular
Hepatectomy
Hepatitis
Liver cancer
Liver neoplasms
Localization
Magnetic resonance imaging
Medical imaging
Metastasis
Original
Patients
Ultrasonic imaging
Ultrasonography
방사선과학
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Summary:The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multicentric small HCCs in 13 patients were histologically diagnosed in the resected specimens. High-frequency IOUS and pathologic findings of these lesions were compared, with particular focus on the presence and appearance of the capsule in or around each lesion. Synchronous multicentric small HCCs were pathologically classified into distinctly nodular (n=12) or vaguely nodular (n=4) types. All 12 distinctly nodular HCCs including six subcentimeter lesions showed detectable capsules on high-frequency IOUS and pathology. The capsules appeared as a hypoechoic rim containing hyperechoic foci (n=6), hypoechoic rim (n=5), or hyperechoic rim (n=1) with varying degrees of coverage around each lesion. Histologically, the capsules were composed of a combination of one to four layers consisting of a fibrous capsule, peritumoral fibrosis, prominent small vessels, and entrapped hepatic parenchyma. Synchronous multicentric small HCCs with distinctly nodular type, even at subcentimeter size, can show capsules with varying coverage and diverse echogenicity on high-frequency IOUS.
ISSN:2288-5919
2288-5943
DOI:10.14366/usg.16001