Classically an encapsulated mass that enchances on arterial phases and washes out w/ enchancing capsule. Difficult to detect on non/p ortal venous phase CT. Slightly hyperintense on T2 may show fluid restriction.
Typically LOCALLY invasive of p ortal / hepatic veins VERSUS cholangiocarcinoma or mets which generally do not have this behavi or.
Maj or criteria f or HCC: Arterial Enhancement or non-peripheral washould on delayed phases Enhancing capsule diameter >50 increase in 6 mo.
Ancillary findings include non-enhancing capsule nodule-in-nodule architecture mosiac architecture fat in mass or blood products in mass
Fibrolamellar Carcinoma is a rare HCC subtype in younger patients without HCC. No AFP elevation. Large heterogenous mass w/ classic central scar that is hypointense on T1+T2.