Table 1 Differential diagnosis between metastatic liver lesions and FELD
Metastatic liver lesion | FELD | |
|---|---|---|
Incidence/100,000 | 8 – 20 | 3 – 4 |
Solitary | 5 – 10% | 90% |
Pathogenesis | Hematogenous or lymphatic spread of cancer | parasitic infestations, allergy, internal malignancies, drug hypersensitivity, and hypereosinophilic syndrome |
Imaging | US, CT | Two-phase dynamic CT, MRI |
Alpha fetoprotein; human chorionic gonadotropin | Elevated (in case of non-seminoma testis) | Normal |
Calcification | Possible | None |
Characteristic gross features | Hemorrhage, necrosis with rim enhancement on CT, spherical shape | indistinct margins, absence of rim enhancement, nonspherical shape |
Characteristic microscopic features | Replacement of hepatocytes, by malignant cells no portal structures | focal eosinophilic accumulation |
Diagnosis | FNAB or core biopsy | FNAB or core biopsy |
Treatment | Resection, RFA or chemotherapy | Depending underlying disease |