Hepatocellular adenoma: An unsolved diagnostic enigma

Figure 2 Diagnostic challenges in the imaging classification of hepatocellular adenoma. A: In a 47-year-old woman the axial T1 in-phase; B: Out-of-phase images show an isointense lesion in liver segment V; C: Hyperintense in the T2-weighted; D: In the diffusion-weighted; E: In the arterial phase images; F: Without washout of the contrast media in the portal-venous phase; G: In the delayed phase images; H: Hypointense in the hepatobiliary phase image. According to the current guidelines, this lesion is suggestive for an inflammatory hepatocellular adenoma. However, it is not possible to exclude a mixed form of β-catenin activated-inflammatory hepatocellular adenoma or even a hepatocellular adenoma inactivated for HNF-1α without fatty component.