Fig. 2.

A 32-year-old man with chronic hepatitis B infection and 151-mm macrotrabecular-massive hepatocellular carcinoma with CT (A–D) and MRI (E–H).

The lesion showed non-rim arterial phase hyperenhancement (B and F, arrows), non-peripheral ‘washout’, and enhancing ‘capsule’ on portal venous phase and delayed phases (C−D and G−H). All readers were concordant with the presence of necrosis or severe ischaemia on both CT and MRI (A and E), and mild−moderate T2 hyperintensity on MRI (E). The observation was categorised as LR-5 by all readers on CT and MRI. Macroscopic examination of the resected specimen (I) showed well-demarcated encapsulated tumour with necrosis change. Microscopic examination (J) showed a macrotrabecular pattern with the area of necrosis consistent with the diagnosis of macrotrabecular-massive hepatocellular carcinoma. CT, computed tomography; MRI, magnetic resonance imaging.