Differential Diagnosis for Multiple Liver Lesions
- Single most likely diagnosis
- Metastatic disease: This is the most common cause of multiple liver lesions, particularly in patients with a history of cancer. The liver is a common site for metastasis due to its rich blood supply and high degree of vascularization.
- Other Likely diagnoses
- Hepatic cysts: These are benign fluid-filled lesions that can be single or multiple. They are often incidental findings on imaging studies.
- Hemangiomas: These are the most common benign liver tumors, composed of blood vessels. They can be single or multiple and are often found incidentally.
- Focal nodular hyperplasia (FNH): This is a benign tumor-like condition of the liver, thought to be a hyperplastic response to an anomalous blood vessel. It can present as a single or multiple lesions.
- Hepatocellular carcinoma (HCC): This is the most common primary liver cancer, often arising in the setting of chronic liver disease or cirrhosis. It can present as a single large lesion or multiple smaller lesions.
- Do Not Miss diagnoses
- Hepatic abscesses: These are collections of pus in the liver, often due to bacterial or parasitic infections. They can present as single or multiple lesions and require prompt treatment to avoid serious complications.
- Echinococcal cysts: These are parasitic cysts caused by the Echinococcus tapeworm. They can present as single or multiple lesions in the liver and can be life-threatening if ruptured.
- Rare diagnoses
- Hepatic lymphoma: This is a rare malignancy of the liver, often presenting as multiple lesions. It can be primary (arising in the liver) or secondary (involvement of the liver by systemic lymphoma).
- Biliary hamartomas (von Meyenburg complexes): These are rare, benign lesions of the bile ducts that can present as multiple small lesions in the liver.
- Intrahepatic cholangiocarcinoma: This is a rare primary liver cancer arising from the bile ducts within the liver. It can present as a single large lesion or multiple smaller lesions.