Courtesy Dr. Siddique Akbar Satti: Ultrasonic Picture of Liver Cirrhosis and HCC

During a teaching session, Dr Siddique Akbar Satti, Head department of medicine, Capital hospital Islamabad, explained in detail the ultrasonic picture of liver cirrhosis with hepatocellular carcinoma.

The 65 year old patient under examination was diagnosed of chronic Hepatitis C 5 years ago. At the time of diagnosis patient already had developed signs of decompensating chronic liver disease. He went through multiple sessions of ascitic tap and supportive therapy in the past 3 years.

At the time of this ultrasonic scan, patient presented with complaints of abdominal distension, swelling of both legs and feet and bluish patches all over the extensor surfaces of upper limbs. Patient was also having intermittent episodes of drowsiness and confusion. He had lost significant weight in the past 6 months, was anorexic and feeling constant dull ache in right hypochondrium.

All these symptoms suggest decompensated liver disease and liver cirrhosis. Worldwide, 25% cases of Hep C associated cirrhosis lead to hepatocellular carcinoma. In the following ultrasonic picture try to note down the abnormalities.

In the above ultrasonic picture you can clearly see the shrunken wood log like appearance of liver.  This coarse texture and shrunken wood log like appearance of liver suggest cirrhosis. In the middle of this wood log like structure you can see a densely hyper-echoic irregularly circular lesion. This suggests hepatocellular carcinoma (also labeled with the help of an arrow). The blackish space between the anterior abdominal wall and margin of liver is fluid (ascites).

So this is all about the ultrasonic view of hepatocellular carcinoma associated with cirrhosis of liver.

 

Special Thanks:

Dr. Siddique Akbar Satti, Head Department of Medicine, Capital Hospital Islamabad.