THE ROCKY LIVER - RADIOLOGIC-PATHOLOGICAL CORRELATION OF CALCIFIED HEPATIC MASSES

Although relatively uncommon in daily clinical practice, calcification may be found in inflammatory hepatic lesions and in benign and malign ant Liver neoplasms. The most common source of calcified hepatic lesio ns is inflammatory conditions such as granulomatous diseases (eg, tube rculosis). The calcification typically involves the entire lesion and appears as a dense mass that can produce artifacts on computed tomogra phic (CT) scans. Echinococcus cysts have curvilinear or ring calcifica tion. Hemangiomas, especially large ones, may contain large, coarse ca lcifications that are centrally located in areas of fibrosis; these ma y be seen at CT (20% of cases) or radiography (10%). In hepatocellular adenoma, calcifications may be solitary or multiple and are usually l ocated eccentrically within a complex heterogeneous mass. Calcificatio ns in fibrolamellar carcinoma have been reported in 15%-25% of cases a t CT and occur in a wide variety of patterns. Calcifications in intrah epatic cholangiocarcinoma are typically accompanied by a desmoplastic reaction and are visible at CT in about 18% of cases. Calcified hepati c metastases are most frequently associated with mucin-producing neopl asms such as colon carcinoma. Knowledge of the pathologic features of each entity helps radiologists to better recognize the shape, size, de nsity, number, location, and distribution of hepatic calcifications se en on images and to narrow the differential diagnosis.