Ultrasound images Adenoma

The hepatic adenoma is a benign focal lesion consisting of a cluster of atypical liver cells (Fig. 4.10). Within this, there may be pools of bile or focal areas of haemorrhage or necrosis. This gives rise to a heterogeneous, patchy echotexture. The smaller ones tend to be homogeneous with a smooth texture.
They are usually less reflective than a haemangioma and may have similar reflectivity to the surrounding liver parenchyma Larger adenomas may contain vigorous arterial flow on Doppler, but this is not pathognomonic and does not differentiate it from a malignant lesion.
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Ultrasound images Adenoma in segment 5 in a young woman on the oral contraceptive pill.
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An unusual
ultrasound images example of cystic degeneration in a large adenoma.
Clinical features
There is a particularly strong association between hepatic adenoma and use of the oral contraceptive so these masses tend to present in younger women.
Adenomas are also associated with glycogen storage disease. They may cause pain, particularly if they haemorrhage, and may be palpable. Surgical removal is the management of choice, although they occasionally regress if the oral contraceptive is discontinued.
Ultrasound is useful in monitoring patients with glycogen storage disease for changes in the charac teristics of their adenomas, as malignant degeneration
is a possible feature.
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