Localized Fibrous Tumor of the Liver: Imaging Features
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Also known as solitary fibrous tumors, or localized fibrous mesothelioma, localized fibrous tumors (LFTs) can occur in numerous different locations including most organs and soft tissues. The archetype of this entity has been described in the pleura, where it accounts for 5% of tumors. On the other hand, LFT of the liver is a very infrequent tumor with no more than 30 cases reported in the English language literature. Hepatic LFT usually manifests with vague abdominal complaints or even mildly abnormal liver blood tests. However, some patients remain asymptomatic and the tumor represents an incidental finding. It generally attains large size before discovery. Patients may also present with hypoglycemia as a paraneoplastic manifestation. Definitive diagnosis of LFT reposes on histology coupled with the characteristic immunological labeling for CD34.
Imaging studies may sometimes suggest the diagnosis. As for any hepatic tumor, multiphasic acquisition, either at computed tomography (CT) scan or magnetic resonance imaging (MRI), is required. It means that after intravenous injection of contrast media, images are obtained during maximal hepatic artery and portal and hepatic veins opacification (~30 and 70 s following the beginning of injection, respectively). Occasionally, delayed images are also obtained (at 5 min or more). Contrast uptake within hepatic lesions is analyzed with respect to these different phases, enabling tumor characterization. For example, hypervascular tumors enhance simultaneously to the hepatic artery. Hypovascular tumors disclose only mild or absent enhancement during the portal phase. Lesions containing a fibrous contingent may enhance only during the delayed phase. Such delayed enhancement is believed to correspond to interstitial contrast diffusion through collagen fibers.
KeywordsFibrous Histiocytoma Solitary Fibrous Tumor Delayed Enhancement Portal Phase English Language Literature
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