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Diagnose und Differenzialdiagnose benigner Lebertumoren und tumorähnlicher Läsionen

Diagnosis and differential diagnosis of benign liver tumors and tumor-like lesions

Der Chirurg volume 79, pages 707–721 (2008)Cite this article

Zusammenfassung

Benigne Lebertumoren und tumorähnliche Läsionen beinhalten ein breites differenzialdiagnostisches Spektrum, welches von dysontogentischen Zysten bis zu Pseudoläsionen reicht. Im klinischen Alltag spielen die fokal noduläre Hyperplasie (FNH), das Adenom und Regeneratknoten die größte Rolle. Bildmorphologisch bietet sich eine Klassifikation in zystische oder solide, solitäre oder multiple, hyper- oder hypovaskularisierte Läsionen an. Das Hämangiom, die FNH, das steroidassoziierte Adenom, das Zystadenom und Echinokokkuszysten lassen sich mit bildgebenden Verfahren zuverlässig diagnostizieren. Gleiches gilt für Pseudoläsionen, die insbesondere in der dynamischen Computertomographie nicht selten sind. Andere Entitäten wie das Adenom in Zirrhose, das Angiomyolipom, Regeneratknoten oder der Echinococcus alveolaris sind nicht hinreichend sicher zuzuordnen und verlangen die bioptische Klärung. Die morphologischen und funktionellen Charakteristika der häufigsten Läsionen in den verschiedenen Modalitäten werden diskutiert. Wenn möglich, wird eine zielführende diagnostische Strategie vorgeschlagen.

Abstract

Benign liver tumors and tumor-like lesions cover a broad spectrum of differential diagnoses, varying from dysontogenetic cysts to pseudolesions. Focal nodular hyperplasia, adenoma and regenerating nodules play a major role in clinical practice. Based on imaging findings, these lesions can be classified as cystic or solid, solitary or multiple, and hyper- or hypovascular. Haemangioma, FNH, steroid-associated adenoma, cystadenoma and echinococcus cysts can be reliably diagnosed using imaging techniques. The same is true for pseudolesions, which are found in particular on dynamic computed tomography. Other entities such as adenoma in cirrhotic livers, angiomyolipoma, regenerating nodules or Echinococcus alveolaris cannot be safely diagnosed by imaging and require biopsy. Morphological and functional characteristics of the most common lesions in the different imaging modalities will be discussed. Where possible, a diagnostic strategy will be presented.

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  1. Institut für Radiologie, Medizinische Hochschule, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    M. Galanski, S. Jördens & J. Weidemann

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  1. M. Galanski
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  2. S. Jördens
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  3. J. Weidemann
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Correspondence to M. Galanski.

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Galanski, M., Jördens, S. & Weidemann, J. Diagnose und Differenzialdiagnose benigner Lebertumoren und tumorähnlicher Läsionen. Chirurg 79, 707–721 (2008). https://doi.org/10.1007/s00104-008-1522-x

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  • DOI: https://doi.org/10.1007/s00104-008-1522-x

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