最小肝細胞癌における超音波像の特徴とその病理組織学的背景

概要

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To differentiate the small hepatocellular carcinoma (HCC) from other hepatic tumors by US, in 6 resected HCC smaller than 2cm in diameter, we compared ultrasonographical findings with histological findings. The results of this study are as follows: 1) Histological septal formation (83.3%) and lobulation (66.7%) can already be seen in the small HCC. 2) Ultrasonographical "septum in nodule" and "nodule in nodule" appearance are in good agreement with histological fibrous septal formation and lobulation. It appears as a hyperchoic septum if the septum course vertically to the beam of ultrasound, and appears as a hypoechoic septum if the septum is curved to the beam of ultrasound. 3) From a cubic structure with serial cut surfaces, fibrous septal formations were due to the penetration of a fibrous capsule. After penetration of fibrous capsule by malignant tissue, the penetrated fibrous capsule remains in the nodule as a septum. 4) In the nodular small HCC with septal formation, the 7 characteristic findings in HCC larger than 15mm can be detected, especially, "septum in nodule" and "nodule in nodule" appearance are most important findings to differenciate small HCC from other malignant or benign tumors.