Abstract
A 69-year-old man diagnosed multiple hepatocellular carcinomas (HCCs) was admitted to our hospital in January 2004. Laboratory analysis of the serum showed positive to HBcAb and PIVKA II 278 mAU/ml. CT during intraarterial injection of contrast medium revealed four nodules showed different intranodular blood supply. One of them that was opacified at digital subtraction hepatic angiography (DSA) was showed hypoattenuation by CT during arterial portography (CTAP) and hyperattenuation by CT during hepatic arteriography (CTHA). Each of other three nodules which was not detected at DSA was showed hypoattenuation by CTAP and isoattenuation by CTHA, hypoattenuation by both CTAP and CTHA, and isoattenuation by both CTAP and CTHA, respectively. Each histologic examination of the three nodules was proven well to moderately HCC, well differentiated HCC with fatty change, well differentiated HCC, respectively. By findings of image and biopsied specimen, this case was proven synchronous multicentric four hepatocellular carcinomas in a patient with liver cirrhosis.
