Follow-up of Focal Liver Lesions Discovered by Ultrasound
It is frequently difficult to ascertain the exact nature of focal liver lesions discovered by ultrasound (US) because of the relatively broad overlap among the US appearances of such lesions. No image is completely pathognomonic. Cysts and small hemangiomas are among the lesions with an almost unequivocal appearance on US, but some necrotic metastases can mimic cysts, and some hyperechoic metastases, e.g., from colon carcinoma, and carcinoid can mimic small angiomas. A second diagnostic procedure is thus necessany in many instances. This step can be fine needle aspiration biopsy (FNAB) but it is nonsense to aspirate every small hepatic lesion (after as many as 2.5% of all ultrasonic examinations in a general hospital and as many as 30% in a cancer institute) just because rare cases are not hemangiomas or cysts.
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