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Hepatic Adenomas: Imaging and Pathologic Findings¹

¹ From the Department of Radiology, University of Brescia, Brescia, Italy (L.G.); the Department of Radiology, University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop St, Rm 4660 CHP MT, Pittsburgh, PA 15213 (M.P.F., G.B., A.B.); the Department of Radiology, Yamanashi Medical University, Nakakoma, Japan (T.I.); and the Department of Radiology, Istituti Ospitalieri di Cremona, Cremona, Italy (L.O.). Recipient of a Certificate of Merit award for a scientific exhibit at the 1999 RSNA scientific assembly. Received August 10, 2000; revision requested October 17 and final revision received December 4; accepted December 11. G.B. supported by the Nicholas Green Fulbright Grant. Address correspondence to M.P.F. (e-mail: federlemp@radserv.arad.upmc.edu).

Hepatocellular adenoma is a rare benign lesion that is most often seen in young women with a history of oral contraceptive use. It is typically solitary, although multiple lesions have been reported, particularly in patients with glycogen storage disease and liver adenomatosis. Because of the risk of hemorrhage and malignant transformation, hepatocellular adenomas must be identified and treated promptly. At pathologic analysis, hepatocellular adenoma is usually a well-circumscribed, nonlobulated lesion, and at gross examination, resected adenomas frequently demonstrate areas of hemorrhage and infarction. Most adenomas are not specifically diagnosed at ultrasonography (US) and are usually further evaluated with computed tomography (CT) or other imaging modalities. Color Doppler US may help differentiate hepatocellular adenoma from focal nodular hyperplasia. Multiphasic helical CT allows more accurate detection and characterization of focal hepatic lesions. Hepatocellular adenomas are typically bright on T1-weighted magnetic resonance images and predominantly hyperintense relative to liver on T2-weighted images. The prognosis of hepatic adenoma is not well established. Criteria that guide treatment include the number and size of the lesions, the presence of symptoms, and the surgical risk incurred by the patient. Understanding the imaging appearance of hepatocellular adenoma can help avoid misdiagnosis and facilitate prompt, effective treatment.

Index Terms: Liver, calcification, 761.814 • Liver, hemorrhage • Liver neoplasms, 761.3192 • Liver neoplasms, CT, 761.1211 • Liver neoplasms, diagnosis, 761.1211, 761.1214 • Liver neoplasms, MR, 761.1214 • Liver neoplasms, US, 761.12983

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