Fibrolamellar carcinoma (liver)

  • 5-35 years age 
  • Arise spontaneously
  • Solitary, lobulated, well-defined tumor with central scar
  • Punctuate calcification within scar in >50% cases
  • Contains fibrotic lamellae and numerous eosinophilic hepatocytes
  • Resection when possible
  • 5-year survival 60%
  • CT: well-defined lobulated, low attenuation mass with even lower attenuation central scar with radial linear components and punctate calcification. Shows non-specific enhancement and delayed enhancement of scar (similar to FNH)
  • MR: low signal of scar in both T1 and T2 (FNH scar is T2 bright)
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Ichikawa, Tomoaki, et al. “Fibrolamellar hepatocellular carcinoma: pre-and posttherapy evaluation with CT and MR imaging.” Radiology 217.1 (2000): 145-151.

Ganeshan, Dhakshinamoorthy, et al. “Imaging features of fibrolamellar hepatocellular carcinoma.” American Journal of Roentgenology 202.3 (2014): 544-552.