Hepatocellular carcinoma with a "nodule-in-nodule" appearance reflecting an unusual dilated pseudoglandular structure

Intern Med. 2008;47(13):1215-8. doi: 10.2169/internalmedicine.47.0640. Epub 2008 Jul 1.

Abstract

We present a case of hepatocellular carcinoma (HCC), showing an atypical "nodule-in-nodule" appearance on ultrasonogram (US). In general, a "nodule-in-nodule" appearance is found as a hyperechoic tumor containing a hypoechoic nodule. In the present case, however, there was a hyperechoic subnodule in the center of the tumor, which was surrounded by a hypoechoic tumor area. Histologically, the subnodule consisted of moderately differentiated HCC with a markedly dilated pseudoglandular structure, and the outer tumor consisted of well-differentiated HCC with a thin-trabecular pattern. It should be noted that there is a rare HCC with dilated pseudoglandular structure showing the inversed "nodule-in-nodule" appearance.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / pathology*
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Ultrasonography