Contrast-Enhanced Ultrasound to Monitor Early Recurrence of Primary Hepatocellular Carcinoma after Curative Treatment

Figure 3

Results for a male patient, aged 55, in whom recurrence occurred 11 years after surgery. A lesion persisted near the first hepatic portal for more than 5 years, and more recent examination suggested that it was growing. The lesion was negative for alpha-fetoprotein. (a) Conventional ultrasound revealed a slightly hyperecho lesion (2.8 × 2.6 cm) in the right lobe near the first hepatic portal area. No significant color flow signal was seen by CDFI. (b) CEUS showed rapid, strong enhancement in the arterial phase, with a range of approximately 1.2 × 1.0 cm. (c, d) CEUS showed isoenhancement in the portal and delayed phases. (e, f) MRI showed no obvious enhancement in the arterial phase and low signal in the hepatobiliary phase. (g) Hematoxylin-eosin staining of pathology biopsy showed many lipid droplets in liver cells and heterogeneous hyperplasia. The ratio of dual nuclear and nuclear plasma was elevated, and nuclei contained inclusion bodies. (f) Pathology staining for reticular fibers showed that the portal area was partially invaded, so the lesion was diagnosed as HGDN.

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