Direct histopathological correlation analysis of ultrasonographical image of minute hepatic cancer nodules: Using formalin-fixed autopsied liver.

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To estimate the direct histopathological correlation analysis of ultrasonographical image of minute hepatic cancer nodules (<15mm in diameter), we used formalin fixed autopsied liver and created the identical liver cut surface to US image plain. The subjects were 12 nodules (hepatocellular carcinoma: 4, metastatic cancer nodule: 8). The size of nodules of liver cut surface (average 8.2×8.1mm) were identical to the size of US image (average 8.4×8.3mm) within 1.0mm difference. The results were as follow; 1. Medullary cancer cells nests were hypoechoic, although only one HCC nodule was hyperechoic. The microscopical differences were not found between hypoechoic HCC ones and hyperechoic one. 2. Fibrous stroma, scar, and coagulation necrosis were isoechoic. 3. Small vessel foci, small hemorrhagic foci, hemorrhagic necrosis, fatty metamorphosis and dilated lymphatics foci were hyperechoic. 4. Perinodular degenerated hepatocytes layer showed hyperechoic ring. Further examination by our method would improved the qualitative ultrasonographical diagnosis of minute hepatic nodules.
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