Liver Lesions: Causes, Types, Symptoms, Diagnosis
What do lesions of the liver mean?
Lesions of the liver means there is an abnormal spot or multiple spots in the liver. By spot, we mean that there is a focal abnormality that is different then the normal liver. This term tells us nothing about the cause of the abnormality alone.
What causes lesions on the liver?
There are many causes of lesions of the liver. There can be one lesion which is benign or cancerous. There can be multiple lesions of liver which can range from benign cysts to cancerous tumors.
Should I be worried about liver lesions?
It depends on what the liver lesions look like. The radiologist reading your scan will provide the most likely diagnosis based on the appearance of the lesions, your clinical history and any prior scans you may have.
Many people have cysts in the liver which can be referred to as lesions. These are usually of no concern. Lesions of the liver can also represent benign or cancerous tumors, liver abscesses (pus pockets), or bleeds from trauma which are more worrisome.
Can liver lesions be cancerous?
Yes they can. We can often tell if liver lesions are cancerous based on their imaging appearance and your history. Further testing may be needed if we can not tell what the liver lesions are. This may include further testing with CT or MRI, biopsy or surgery.
Benign lesions of liver
Benign lesions of liver can include cysts.
Benign tumors can include hemangiomas, focal nodular hyperplasia, hemangioma, adenoma in addition to others.
Benign lesions can also represent perfusion or blood vessel abnormalities.
Fatty Infiltration or sparing of liver can represent lesions of liver. These are benign abnormalities where there is extra fat storage in the liver.
Inflammatory changes of liver can represent lesions. This includes abscesses or pockets of pus.
Focal areas of bleeding in the liver can represent liver lesions. This can be from trauma or preexisting lesions which have bled.
Malignant liver lesions
Many liver tumors can be seen in the liver such as hepatocellular carcinoma or liver cancer. There are many other types of cancers of the liver such as cholangiocarcinoma, lymphoma, sarcoma to name some. Cancers from other parts of the body can spread to the liver.
Liver lesions on CT scan
Liver lesions on CT scan can represent benign or cancerous abnormalities. Often CT allows us to diagnose liver lesions based on the appearance. Further testing may be needed when it is not clear from the CT what the diagnosis is.
Multiple liver lesions on a CT scan
Multiple liver lesions on CT scan can be benign or cancerous. CT can often allow a diagnosis to be made.
What is a low density lesion on a CT scan?
Low density lesion on CT scan is one which is darker then the liver. This is a descriptive term and tells us nothing about the cause.
Low attenuation lesions in liver
Low attenuation lesions in the liver are those which are darker then the liver on CT. This tells us nothing about the cause of the lesions. These can be benign or malignant.
Liver lesions on MRI
Liver lesions can also be seen on MRI of the abdomen. MRI is good for identifying the cause of the liver lesions. MRI lets us look at the lesions on multiple different types of sequences. This means we get multiple looks at the liver lesions and their tissue properties. This can better allow us to arrive at a cause.
T2 hyperintense lesions liver
This is a descriptive term used in MRI to describe a lesion that is bright on the T2 sequence. This tells us nothing about what the lesions is by itself. A T2 sequence is a type of technique used in MRI.
Liver lesions on ultrasound
Liver lesions on ultrasound can be characterized as cystic or solid. Cystic lesions are those which contain fluid. Solid lesions are those which contain solid components. We often can not tell what liver lesions are on ultrasound alone. Additional imaging with CT or MRI is often needed.
Too small to characterize liver lesions
These are usually lesions under a centimeter. We often can not tell with confidence what they are. These are commonly benign cysts or other benign tumors in patients who do not have cancer. Those with cancer of liver disease may need close follow up.
Focal liver lesions
This is another way of saying there is a liver lesion that involves a spot in the liver rather than more extensive areas.
Single vs multiple liver lesions
The cause of single versus multiple liver lesions depends on the appearance seen on imaging. We can have a single or multiple liver lesions be benign or cancerous.
Symptoms of liver lesions
Many benign and even cancerous lesions of the liver can have no symptoms. They can be found when you have abdominal imaging done for different reasons.
If you do have symptoms, this can depend on the type of lesion. You can have abdominal pain, swelling, a feeling of fullness, weight loss, fatigue, yellowing of the eyes and skin (jaundice), fever.
Liver lesions treatment
The treatment will depend on what the lesion is. Many benign lesions like cysts and hemangiomas are left alone. Liver tumors may need cancer treatment or surgery. Abscesses will need antibiotics and drainage.
Liver lesions: further testing
Often more then one imaging test will be needed for diagnosis. Liver focused CT or MRI is needed at times for diagnosis of liver lesions. PET CT is needed when there is suspicion of cancer in the body which has spread to the liver. Biopsies are more definitive as the liver lesion can be diagnosed by a pathologist.
Liver lesions: summary
Liver lesions can be benign or cancerous. This term tells us nothing about the appearance, diagnosis or prognosis. It only tells us something is wrong in the liver. The radiologist reading your scan will often give a diagnosis or the possibilities. He will also recommend further testing when appropriate.