A case of hepatocellular carcinoma of pseudograndular type visualized as the hyperechoic pattern on ultrasonography

A case of hepatocellular carcinoma with pseudograndular proliferation showed hyperechoic pattem in ultrasonogram was reported. A 71-year-old male was admitted to our hospital with a complaint of abdominal pain in the right upper quadrant. Ultrasonogram revealed a hyperechoic mass about 6.7cm×6.2cm in the right posterior segment of the liver. At surgery, a right hepatectomy was performed and the resected liver was examined histopathologically. The pathologic diagnosis was hepatocellular carcinoma of Edmondson Gr. II without cirrhosis, and diffuse pseudograndular proliferation in the tumor was visualized. It had been reported that the hyperechoic area in hepatocellular carcinoma reflected nonliquefactive necrosis, fatty metamorphosis and severe sinusoidal dilatation. We suggest that a site of extensive pseudograndular proliferation should be also visualized as a hyperechoic area ultrasonographically.