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[Unknown liver lesions].

Christoph Roderburg, Sven H Loosen, Philipp Bruners

    Deutsche Medizinische Wochenschrift (1946)
    |November 22, 2019
    PubMed
    Summary
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    Differentiating benign from malignant liver lesions is crucial. This review outlines common benign and malignant focal liver lesions, emphasizing the need to confirm benignity and exclude malignancy.

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    Area of Science:

    • Hepatology
    • Diagnostic Imaging
    • Pathology

    Background:

    • Unknown liver lesions are frequently detected during routine examinations, posing a diagnostic challenge.
    • Prevalence varies, with autopsy studies showing focal liver lesions in up to 50% of men aged 35-69.
    • Distinguishing benign lesions (over 95% in asymptomatic individuals) from those in patients with underlying diseases is critical.

    Purpose of the Study:

    • To provide a comprehensive overview of common benign and malignant focal liver lesions.
    • To emphasize the diagnostic goal of confirming benignity and excluding malignancy.
    • To guide the classification of benign liver lesions.

    Main Methods:

    • Literature review of forensic autopsy series and diagnostic work-up protocols.
    • Categorization of liver lesions based on prevalence and clinical significance.
    • Description of characteristic benign and malignant entities.

    Main Results:

    • Common benign lesions include liver cysts, focal fatty liver, hemangiomas, FNH, and adenomas.
    • Less frequent benign entities include abscesses and extramedullary hematopoiesis.
    • Frequent malignant lesions are metastases, hepatocellular carcinoma (HCC), and cholangiocellular carcinoma (CCA).

    Conclusions:

    • Accurate diagnosis of liver lesions is essential for appropriate patient management.
    • Confirming benignity and reliably excluding malignancy are primary diagnostic objectives.
    • Detailed classification aids in understanding the nature of benign liver lesions.