Differential Diagnosis for Hypodense Masses in Liver at CT Scan
- Single Most Likely Diagnosis
- Simple hepatic cysts: These are the most common cause of hypodense liver masses and are usually benign, fluid-filled lesions that can be multiple and vary in size.
- Other Likely Diagnoses
- Hemangiomas: These are benign vascular tumors of the liver, often appearing hypodense on CT scans due to their vascular nature and may show characteristic peripheral nodular enhancement.
- Focal fatty change or fatty sparing: These conditions result from variations in fat distribution within the liver and can appear as hypodense areas on CT scans, often related to metabolic or nutritional factors.
- Pyogenic liver abscess: Although typically appearing as a fluid collection, in some cases, especially in the early stages or with certain types of infections, liver abscesses can present as hypodense masses.
- Do Not Miss Diagnoses
- Hepatocellular carcinoma (HCC): Although often more dense due to its vascular nature, HCC can occasionally appear hypodense, especially in the context of a background of liver disease like cirrhosis. Missing this diagnosis could be fatal.
- Metastases: Certain metastatic lesions to the liver, such as those from lymphoma or some gastrointestinal primaries, can appear hypodense. Given the potential for malignancy, these should not be overlooked.
- Amoebic liver abscess: Caused by Entamoeba histolytica, these abscesses can appear as single or multiple hypodense lesions in the liver and require prompt treatment to avoid complications.
- Rare Diagnoses
- Biliary cystadenoma or cystadenocarcinoma: These are rare, benign or malignant, cystic neoplasms of the liver that can appear hypodense on CT scans due to their fluid content.
- Polycystic liver disease: A rare condition characterized by multiple cysts within the liver, which can appear as multiple hypodense masses on imaging.
- Hydatid cysts: Caused by Echinococcus granulosus, these parasitic cysts can appear as hypodense masses in the liver, often with characteristic calcifications in the cyst wall.