Liver benign solid lesion

Molina EG, Schiff ER (1999) Benign solid lesion of the liver. In Schiff ER (ed) Diseases of the liver. Lippincott-Raven, pp 1254-1257... 

Radiological Appearance of Different Focal Liver Lesions 397 Solid Benign Lesions 397 Metastatic Liver Lesions 399 Lesions in the Cirrhotic Liver 400 Other Lesions 401... 

The differential diagnosis for focal liver lesions includes benign and malignant lesions (metastatic, recurrent or primary) and the parenchymal manifestations of arterial abnormalities, infarcts, and abscesses. Infarcts usually appear as round or geographic solid lesions, with central hypoechoic necrotic areas. Abscesses have thick walls and central hypoechoic areas. Infarcts and abscesses may contain intraparenchymal gas (Fig. 4.2.16). 

The prevalence of solid benign liver tumours has been reported to be more than 20% in autopsy series and in patients with malignancy 25-50% of lesions under 2 cm in size are benign (Karhunen 1986 Edmunson and Craig 1987 Jones et al. 1992 ... 

As discussed above, solid benign liver lesions are very common. It is therefore of the utmost importance to differentiate these from metastases in cancer patients. Unenhanced US is usually not able reliably to differentiate metastases from other lesions. Conversely, the use of contrast agents achieves this goal in most cases, since all common solid benign liver lesions have characteristic dynamic imaging features on contrast-enhanced US and their diagnosis is thus usually unproblematic. Most of these features are analogous to those on dynamic CT and MR. 

---