Table 2 Differential diagnosis for liver calcifications
From: Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis
Differential diagnosis for liver calcifications | Prevalence | Pattern of calcifications | Notes | |
|---|---|---|---|---|
Parasitic infections | Alveolar echinococcosis | Very common at all stages | Diffuse > Scattered > Focal | Patient from endemic areas Hypoattenuating infiltrative mass, absence of contrast enhancement |
Cystic echinococcosis | May be observed at all stages | Concerns the cyst wall | Patient from endemic areas Circumscribed liver cyst with heterogeneous content (detached membrane or internal cysts) | |
CE1: rare | Sprinkled | |||
CE2: common | Sprinkled > eggshell-like = circular or content | |||
CE3: common | Eggshell-like > sprinkled = circular or content | |||
CE4: common | Eggshell-like > sprinkled | |||
CE5: very common | Circular or content = eggshell-like > sprinkled Partially or entirely calcified cyst | |||
Cystic lesions | Cystadenoma/cystadenocarcinoma | 8 to 25% | Coarse mural and septal | Cystic lesion with enhanced septa Wall nodule in cystadenocarcinoma |
Liver cysts | Rare | Non-circumferential | Non-enhancing simple cystic lesion | |
Solid tumors | Cholangiocarcinoma | Rare | Solitary or multiple Ill-defined | Infiltrative mass with delayed enhancement |
Hepatocellular carcinoma (HCC) | Rare (more common after therapy) | Variable | Early enhancement and wash out of solid component in cirrhotic liver | |
Fibrolamellar HCC | Very common (40 to 70%) | Calcified central scare | Young adult, large lobulated lesion with central scar in normal liver | |
Metastasis | Common in  Mucinous carcinoma/osteosarcoma  Treated metastasis | Variable | Multiple lesions | |
Hemangioma | Rare More frequent if big size | Central and coarse | Peripheral discontinuous enhancement, then centripetal | |