Question 2403
{"accessible":false,"alternatives":[{"id":11831,"text":"are \u003c50 years old"},{"id":11832,"text":"are on dialysis"},{"id":11834,"text":"have a low hemoglobin level"},{"id":11833,"text":"have chronic hepatitis"}],"archived":false,"correctAlternativeId":11833,"explanation":"\u003cp\u003eSmall echogenic lesions in the liver are often seen incidentally and are most often benign hemangiomas that do not require further evaluation. Caution should be exercised when:\u003c/p\u003e\u003col\u003e\u003cli\u003ethe liver is a source of referring clinician concern (e.g. not truly “incidental”)\u003c/li\u003e\u003cli\u003eif the patient has a history of malignancy\u003c/li\u003e\u003cli\u003eif the patient has a history of chronic hepatitis and/or cirrhosis\u003c/li\u003e\u003c/ol\u003e\u003cp\u003eNever call a new echogenic lesion in a cirrhotic liver a hemangioma without proving it by some other means.\u003c/p\u003e\u003cp\u003eRelative indications for further work are multiple echogenic lesions, a large lesion (\u0026gt;3 cm), and/or if the patient is older than 50 years old. Although many of these lesions turn out to be hemangiomas, the risk for malignancy is no longer negligible.\u003c/p\u003e","id":2403,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2403","nextQuestionPath":"/articles/generalised-increase-in-hepatic-echogenicity/questions/2402","relatedArticles":[{"id":1415,"title":"Hemangioma","link":"/articles/haemangioma?lang=us"},{"id":17361,"title":"Coarsened hepatic echotexture","link":"/articles/coarsened-hepatic-echotexture?lang=us"}],"alsoUsedIn":[{"id":1314,"kind":"Course","title":"2022 Virtual Conference Private Use - page 1314","link":"https://radiopaedia.org/courses/2022-virtual-conference-private-use/pages/1314"},{"id":1314,"kind":"Course","title":"X-ray \u0026 Ultrasound Lectures - page 1314","link":"https://radiopaedia.org/courses/xray-lectures/pages/1314"}],"stem":"\u003cp\u003eYou are seeing a new patient, and are about to call a small echogenic lesion in the liver a hemangioma. You should be more cautious and consider CT or MRI as a follow-up if they...\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2403"}],"attemptsPercentages":[{"alternativeId":"11832","percentage":2},{"alternativeId":"11834","percentage":4},{"alternativeId":"11833","percentage":90},{"alternativeId":"11831","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"generalized-increase-in-hepatic-echogenicity"}