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Magnetic resonance (MR) features of five primary malignant mesenchymal neoplasms (plasmocytoma, leiomyosarcoma, undifferentiated sarcoma, epithelioid hemangioendothelioma, and angiosarcoma) of the liver were reported. All tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. No halo and intravenous extension were noted. A target appearance was revealed in epithelioid hemangioendothelioma. MR findings of angiosarcoma were essentially the same as those of cavernous hemangiomas (markedly hyperintense with hypointense linear septa on T2-weighted images). MR findings of these rare hepatic malignancies were nonspecific, although they were quite different from those of typical hepatocellular carcinomas. This study suggested that MR differentiation of primary hepatic mesenchymal tumors from other common benign and malignant neoplasms was difficult; however, the number of studied cases was limited.

An atypical case of multilocular cystic hemangioma is presented. A 4.5 cm multilocular cystic mass was incidentally found in a 66-year-old healthy woman on ultrasound screening. CT, MR imaging, and angiography were performed: however, the features that are characteristic of cavernous hemangioma were not obtained. The final diagnosis could not be made until surgery.

Dense accumulation of Lipiodol in hepatic segmental parenchyma was studied by computed tomography (CT) after transarterial chemoembolization (TACE) for hepatic tumor. Six patients showed dense accumulation of Lipiodol in hepatic segmental parenchyma on CT two weeks after TACE. Four of the six showed parenchymal accumulation of Lipiodol as dense as that in a tumor at three weeks after TACE. Therefore, it was considered that evaluation with CT should be performed after one month or more in order to differentiate between Lipiodol accumulation in tumors and that in non-neoplastic liver parenchyma.

Iodized-oil CT in a patient with chronic liver disease revealed focal accumulation of iodized oil in an exophytic mass. Single photon emission CT (SPECT) with [99mTc]phytate showed the existence of functioning Kupffer cells, excluding hepatocellular carcinoma. Biopsy revealed a regenerating nodule. Positive iodized-oil CT does not always indicate hepatoma. In such cases, SPECT with [99mTc]phytate will help to make a correct diagnosis.

We report an unusual case of multilocular cystic cavernous hemangioma of the liver. The patient was a 61-year-old woman without liver disfunction but who had multicystic mass lesions in the liver. Although cavernous hemangiomas are usually accurately diagnosed by the various imaging modalities, our case showed atypical features.

One-hundred and fourteen cases of hepatocellular carcinoma (HCC) which underwent computed tomography (CT) and angiography at the University Hospital of Yamanashi were reviewed. These included 24 cases of HCC associated with hepatic schistosomiasis japonica. Compared with the other cases, radiological features of HCC with schistosomiasis japonica were clarified. Patients with multinodular HCC were most common (13/24), followed by those with single nodular HCC (7/24), while those with massive or diffuse HCC were few (4/24). In patients with marked CT changes (grade III or IV) of hepatic schistosomiasis japonica, most of HCC nodules were disclosed as a mass with homogenous hypodensity surrounded by "shell-like calcifications". Obstruction of the portal vein or its branches due to tumor thrombus was rarely noted (4/24). These features are presumably attributed to periportal fibrosis which is characteristic of heptic schistosomiasis japonica. Because of these features, it is expected that hepatocellular carcinomas with schistosomiasis japonica can be treated by transcatheter arterial embolization more effectively than those without schistosomiasis japonica.

Cis-Diamminedichloroplatinum (CDDP)-lipiodol suspension (CLS) was developed as a transarterial chemoembolization (TACE) material. The CLS was injected into the proper hepatic artery or distal branches of patients with hepatocellular carcinoma. Strong anticancer effects were observed. Plasma concentrations of total and filtrable CDDP following TACE were much lower than those following intravenous administration of CDDP solution. No major adverse complications were noted, presumably due to low CDDP concentrations in circulating plasma. The CLS appears to be an excellent TACE material.

Out of 79 consecutive cases of hepatocellular carcinoma (HCC) examined with computed tomography (CT), five patients revealed metastatic swollen abdominal lymph nodes. Involved were portal, retropancreatic, common hepatic, superior mesenteric, and paraaortic nodes. CT appeared to be an excellent modality in the diagnosis of metastatic abdominal lymph nodes of HCC.