Journal of Ultrasound in Medicine, Vol 19, Issue 4 231-234, Copyright © 2000 by American Institute of Ultrasound in Medicine
Non-Asian hepatocellular carcinoma: correlation between histologic features and echogenicity
R. H. Wachsberg, K. M. Klein and S. Von Hagen
Department of Radiology, UMDNJ-New Jersey Medical School, Newark, USA.
Studies of hepatocellular carcinoma in Asia have revealed a correlation
between lesion hyperechogenicity and five histologic features: nonliquefied
necrosis, sinusoidal dilatation, hemorrhage, fatty metamorphosis, and
fibrosis. However, this correlation has not been investigated for non-Asian
hepatocellular carcinoma, despite substantial differences between the Asian
and non-Asian forms of this carcinoma. We retrospectively reviewed records
of 29 patients seen at one United States institution who had hepatocellular
carcinoma lesions that were either completely hyperechoic or completely
hypoechoic. Tissue specimens obtained surgically (n = 7) or percutaneously
(n = 22) were evaluated microscopically for the presence of nonliquefied
necrosis, sinusoidal dilatation, hemorrhage, fatty metamorphosis, and
fibrosis. A statistically significant correlation was identified between
the number of histologic features identified and lesion diameter (P = 0.04)
but not between the number of histologic features identified and the
likelihood of hyperechogenicity (P = 0.11). Two lesions (50%) with three
histologic features, four lesions (40%) with two histologic features, and
six lesions (55%) with one histologic feature were hypoechoic. The
echogenicity of non-Asian hepatocellular carcinoma lesions cannot be
attributed to the histologic features that are believed to underlie
echogenicity of the Asian type of hepatocellular carcinoma.
