MRI Characteristics of Primary Liver Malignancies: Common and Uncommon Mimics with Histopathological Correlation - A Practical Approach
Nikhar Kinger1, Sadhna Nandwana1, Courtney Moreno1, Kelly Cox1, and Pardeep Mittal1

1Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States


The liver is an important oncologic organ. Primary liver tumors can arise from a variety of different liver components such as hepatocytes, bile duct epithelium, neuroendocrine cells, and mesenchymal cells. We will discuss imaging and histopathological features of primary liver tumors and their common and uncommon mimics.

Learning Goals:

1. To demonstrate MRI characteristics of primary liver cancers in chronic liver disease (CLD) and non-CLD and differentiating features.

2. To describe common and uncommon mimics of primary liver cancers and overlapping features.

3. To describe histopathological features of primary liver malignancies and their mimics.

4. To demonstrate characteristics of primary liver tumors in the pediatric population.

Background Information and Content:

This presentation includes review of MRI examinations of patients for characterization of liver lesions in CLD and non-CLD using dedicated MRI protocol using extracellular and hepatobiliary contrast agents and without. MRI findings will be correlated with histopathological findings.

The liver is an important organ from an oncologic perspective. Primary liver cancers are more common in the presence of CLD such as cirrhosis, hemochromatosis, etc., than non-CLD. Primary liver tumors arise from different components of the liver such as hepatocytes, bile duct epithelium, neuroendocrine cells and mesenchymal cells. Hence we will discuss imaging and histopathological features of hepatocellular carcinoma, cholangiocarcinoma, cholangiocellular carcinoma, epithelioid hemangioendothelioma, angiosarcoma, lymphoma etc. and their common and uncommon mimics such as FNH, neuroendocrine tumors, lymphoepithelioma, extramedullary hematopoiesis, inflammatory tumors, sclerosing hemangioma. The patient’s age is also an important discriminating factor because some tumors occur in the pediatric age group such as hepatoblastoma, mesenchymal hamartoma, infantile hemangioendothelioma etc.


MRI has evolved into a vital diagnostic tool due to its excellent intrinsic soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation. These factors significantly contribute to the diagnostic accuracy, successful management, and follow up.


No acknowledgement found.


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Combined HCC and Cholangiocarcinoma

Epithelioid Hemangioendothelioma

Hepatic Angiosarcoma

Lymphoma Infiltrating Type


Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)