Liver mass differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]; Dildar Hussain, MBBS [3]; Aditya Ganti M.B.B.S. [4]
Overview
Overview
Liver mass must be differentiated from the diseases that cause abdominal pain, pruritus, low-grade fever, and ascities such as angiomyolipoma, adenoma, borderline (high-grade dysplastic) nodule, cholangiocarcinoma, confluent fibrosis, focal nodular hyperplasia, focal fat sparing and deposit on liver, gallbladder cancer, hereditary hemorrhagic telangiectasia, inflammatory pseudotumors, liver hemangioma, hepatoblastoma in children, pyogenic liver abscesses, pancreatic cancer, Stomach cancer.
Common Differential Diagnosis
Common Differential Diagnosis
Liver mass must be differentiated from the following diseases that cause abdominal pain, pruritus, low-grade fever, and ascities such as:[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][16][17][18][19][20][21][22][13][23][24][25][26][27]
Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram
| Disease | Clinical manifestations | Diagnosis | Comments | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | |||||||||||||||
| Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | ||
| Hepatocellular carcinoma/Metastasis | RUQ | + | β | + | + | + | + | + | + | + | β | + |
|
|
Other symptoms: | |
| Cholangiocarcinoma | RUQ | + | β | + | + | β | β | + | β | β | β | + | Normal |
|
| |
| Pancreatic carcinoma | MidEpigastric | β | β | + | + | + | β | + | β | β | β | + | Normal |
|
Skin manifestations may include: | |
| Focal nodular hyperplasia | Diffuse | Β± | β | β | Β± | β | β | + | + | β | β | β | Normal |
|
|
|
| Disease | Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | Comments |
| Gallbladder cancer | Midepigastric | β | β | + | + | β | + | + | β | β | β | β | Normal |
|
|
|
| Liver hemangioma | Intermittent RUQ | β | β | + | + | β | β | β | β | β | β | β | Normal |
|
| |
| Liver abscess | RUQ | + | β | + | + | β | β | + | β | β | β | β | Normal |
|
|
|
| Cirrhosis | RUQ+Bloating | + | β | + | + | β | β | + | β | β | β | β | Normal |
|
US
|
|
| Inflammatory lesions | RUQ | Β± | β | + | + | β | β | β | β | β | β | β | Normal |
|
US
|
|
References
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- β {{cite
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- β . doi:10.1102/1470-7330.2009.0015. Missing or empty
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