Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2011; 17(7): 946-952
Published online Feb 21, 2011. doi: 10.3748/wjg.v17.i7.946
Primary clear cell carcinoma in the liver: CT and MRI findings
Qing-Yu Liu, Hai-Gang Li, Ming Gao, Xiao-Feng Lin, Yong Li, Jian-Yu Chen
Qing-Yu Liu, Ming Gao, Xiao-Feng Lin, Yong Li, Jian-Yu Chen, Department of Radiology, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
Hai-Gang Li, Department of Pathology, The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou 510120, Guangdong Province, China
Author contributions: Liu QY designed the study and wrote the manuscript; Gao M, Li Y and Chen JY contributed to the analysis and interpretation of data; Li HG performed the pathological analysis; Lin XF contributed to the statistical analysis.
Correspondence to: Qing-Yu Liu, PhD, Department of Radiology, The Second Affiliated Hospital of Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou 510120, Guangdong Province, China.
Telephone: +86-20-81332243 Fax: +86-20-81332702
Received: August 29, 2010
Revised: December 1, 2010
Accepted: December 8, 2010
Published online: February 21, 2011

AIM: To retrospectively analyze the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of primary clear cell carcinoma of the liver (PCCCL) and compare the imaging appearances of PCCCL and common type hepatocellular carcinoma (CHCC) to determine whether any differences exist between the two groups.

METHODS: Twenty cases with pathologically proven PCCCL and 127 cases with CHCC in the Second Affiliated Hospital of Sun Yat-sen University were included in this study. CT or MRI images from these patients were retrospectively analyzed. The following imaging findings were reviewed: the presence of liver cirrhosis, tumor size, the enhancement pattern on dynamic contrast scanning, the presence of pseudo capsules, tumor rupture, portal vein thrombosis and lymph node metastasis.

RESULTS: Both PCCCL and CHCC were prone to occur in patients with liver cirrhosis, the association rate of liver cirrhosis was 80.0% and 78.7%, respectively (P > 0.05). The mean sizes of PCCCL and CHCC tumors were (7.28 ± 4.25) cm and (6.96 ± 3.98) cm, respectively. Small HCCs were found in 25.0% (5/20) of PCCCL and 19.7% (25/127) of CHCC cases. No significant differences in mean size and ratio of small HCCs were found between the two groups (P = 0.658 and 0.803, respectively). Compared with CHCC patients, PCCCL patients were more prone to form pseudo capsules (49.6% vs 75.0%, P = 0.034). Tumor rupture, typical HCC enhancement patterns and portal vein tumor thrombosis were detected in 15.0% (3/20), 72.2% (13/18) and 20.0% (4/20) of patients with PCCCL and 3.1% (4/127), 83.6% (97/116) and 17.3% (22/127) of patients with CHCC, respectively. There were no significant differences between the two groups (all P > 0.05). No patients with PCCCL and 2.4% (3/127) of patients with CHCC showed signs of lymph node metastasis (P > 0.05).

CONCLUSION: The imaging characteristics of PCCCL are similar to those of CHCC and could be useful for differentiating these from other liver tumors (such as hemangioma and hepatic metastases). PCCCLs are more prone than CHCCs to form pseudo capsules.

Keywords: Clear cell carcinoma, Hepatocellular carcinoma, Pathology, Magnetic resonance imaging, Computed Tomography, X-ray