Characteristics of common solid liver lesions and recommendations for diagnostic workup

Table 1 Clinical differential diagnosis of the most common liver masses

	Cirrhotic liver	Common lesions	Non-cirrhotic liver	Common lesions
Malignant mass	Hepatocellular carcinoma	a,d	Metastasis	a,b
	Cholangiocarcinoma		Well differentiated HCC
	High grade dysplastic nodule		Fibro lamellar HCC	a,b,c,g
	Lymphoma		Cholangiocarcinoma
	Metastasis (exceptional)		Hemangio-Endothelioma	g
			Lymphoma
			Melanoma
			Neuroendocrine tumor	a
			Sarcoma (angiosarcoma,leiomyosarcoma)	g
Benign mass	Low grade dysplasia	d	Hemangioma	b
	Focal fatty liver		Focal nodular hyperplasia (FNH)	a,b
	Hemangioma		Hepatic adenoma (HA)	a,b
	Hepatic adenoma	g	Nodular regenerative hyperplasia	b,f
			Partial nodular transformation	e,f
			Focal fatty infiltration	c,e
			Bile duct adenoma

a: Hyper vascular liver tumor; b: Tumors that are extremely rare in cirrhosis but relatively frequent in healthy normal liver; c: Tumors frequent in the left lobe; d: Mainly in cirrhosis; e: Equally found in cirrhotic and non cirrhotic; f: Clinically mimics cirrhosis; g: Extremely rare tumors.