Differential Diagnosis for PET Negative Liver Fulum Mass
Single Most Likely Diagnosis
- Focal fatty change or focal fatty sparing: This is a common benign condition that can cause a mass-like appearance on imaging, and the fact that it's PET negative suggests a non-malignant process.
Other Likely Diagnoses
- Hemangioma: A common benign liver tumor that is often incidentally discovered and can appear as a mass on imaging. The PET negativity supports a benign diagnosis.
- Hepatic adenoma: A rare benign liver tumor that can appear as a mass, although it's less likely than hemangioma. PET negativity is consistent with a benign process.
- Regenerative nodules: These can occur in the setting of chronic liver disease and can appear as masses on imaging. The PET negativity suggests a non-malignant process.
Do Not Miss Diagnoses
- Hepatocellular carcinoma (HCC) with low metabolic activity: Although HCC is typically PET positive, some well-differentiated tumors may have low metabolic activity and appear PET negative. Missing this diagnosis could be deadly.
- Intrahepatic cholangiocarcinoma: This is a malignant tumor that can appear as a mass on imaging and may be PET negative, especially if it's well-differentiated. Missing this diagnosis could be deadly.
- Metastasis from a PET negative primary tumor: Some primary tumors, such as prostate or neuroendocrine tumors, may not be PET avid, and their metastases may also be PET negative. Missing this diagnosis could be deadly.
Rare Diagnoses
- Biliary cystadenoma or cystadenocarcinoma: These are rare benign or malignant tumors of the biliary tree that can appear as masses on imaging. The PET negativity is consistent with a low-grade or benign process.
- Inflammatory pseudotumor: A rare benign condition that can cause a mass-like appearance on imaging. The PET negativity supports a benign diagnosis.
- Lymphoma: A rare malignant tumor that can involve the liver and appear as a mass on imaging. The PET negativity is unusual, but some types of lymphoma may not be PET avid.