Differential Diagnosis for Multiple Scattered Nodules in the Liver
Single Most Likely Diagnosis
- Metastatic Disease: This is often the most common cause of multiple liver nodules, especially in patients with a known history of cancer. The liver is a common site for metastasis due to its rich blood supply and high metabolic activity.
Other Likely Diagnoses
- Hemangiomas: These are benign tumors composed of blood vessels and are the most common benign liver lesions. They can appear as multiple nodules on imaging.
- Focal Nodular Hyperplasia (FNH): A benign condition characterized by nodular hyperplastic liver tissue, often appearing as multiple nodules.
- Hepatic Adenomas: Benign liver tumors that can appear as multiple nodules, especially in patients with a history of oral contraceptive use or anabolic steroid use.
Do Not Miss Diagnoses
- Hepatocellular Carcinoma (HCC): A primary liver cancer that can present as multiple nodules, especially in patients with risk factors such as cirrhosis, hepatitis B or C infection, or alcohol abuse. Missing this diagnosis could be fatal.
- Infectious Diseases (e.g., Abscesses, Tuberculosis): Certain infections can cause multiple liver nodules and have a high morbidity and mortality if not promptly treated.
Rare Diagnoses
- Lymphoma: Can involve the liver and present as multiple nodules, though this is less common.
- Liver Involvement in Systemic Diseases (e.g., Sarcoidosis, Langerhans Cell Histiocytosis): These conditions can rarely cause multiple liver nodules.
- Biliary Hamartomas (Von Meyenburg Complexes): Benign biliary malformations that can appear as multiple small nodules in the liver.