FIBROLAMELLAR HEPATOCELLULAR-CARCINOMA - AN ATYPICAL MR MANIFESTATION

We report the imaging findings, specifically magnetic resonance pictur es of a non-cirrhotic case of fibrolamellar hepatocellular carcinoma i n an older patient (60 years). Computed tomography revealed non-enhanc ed hypodense central scar without notable intratumoral calcification. MR imaging revealed a mass, which was homogeneously hypointense on T1- weighted images (T1WI) and turned hyperintense on T2-weighted images ( T2WI). Stellate central scar was depicted with more hypointensity on T 1WI, however, it became markedly hyperintense on T2WI. This manifestat ion is very different from the typical pattern reported in the literat ure. In gadolinium enhanced T1WI, the mass other than the central scar got enhanced. Fibronodular hyperplasia and fibrolamellar hepatocellul ar carcinoma should be differentiated with reference to the clinical a nd imaging findings. Collagenous central scar was described pathologic ally within the latter. However, a discrepancy between the pathologica l and magnetic resonance pattern concerning the central scar which was collagenous and corresponding to hyperintensity on T2WI was found. To our knowledge no similar entity has been described in the literatures so far.