Differential Diagnosis of Benign Liver Tumors

The differential diagnosis of a suspect liver tumor must take into account epidemiology and the patient clinical background. The most commonly detected benign liver lesions which enter into the differential diagnosis with the previously discussed liver tumors are abscesses and granulomas; single or multiple areas of hepatic steatosis or fatty sparing, other inflammatory lesions, traumatic outcomes and congenital malformations. The diagnosis of focal and multifocal steatosis or focal fatty sparing is simple with MRI that exploits the chemical shift technique. Liver abscesses are usually avascular lesions with a kind of enhancing pseudocapsule, a complete examination of the liver, biliary tract, and abdomen is useful to identify the source of infection. For most of these lesions, clinical and laboratory data may provide the necessary information, and a definitive diagnosis is reached by abdominal US. However, in case of lesions detected in patients with history of cancer or chronic liver disease, a contrast-enhanced examination with CT or MR is frequently indicated. When nontypical imaging features are present, a percutaneous biopsy or surgical resection may be necessary.