Images and text Genevieve Carbonatto
An abdominal ultrasound is performed on a young woman for right upper quadrant pain. This is what is seen while scanning through the liver
This is a cavernous haemangioma. It looks like a snowball on ultrasound.
Characteristics of haemangiomas:
- Blood filled cavernous space lined with a single layer of flat endothelial cells and seperated by fibrous septa.
- Usually less than 3 cm
- Uniformly hyperechoic
- May be associated with acoustic enhancement
- Common and benign affecting 0.5 – 20% of the general population
- Found mainly in 30 -40 year olds
- 3 -5 X more frequent in women
- May be multiple in 10 -50% of cases
- May be found anywhere but they are usually peripheral and subcapsular in the posterior segments of the right lobe
- Asymtomatic if small. If over 5 cm they may cause inflammation causing rapid tumour growth associated with fever, weight loss and abdominal pain
- Colour Doppler will not show slow moving blood in the sinuses. If Doppler flow is readily detectable then this is a concerning feature.
In a young patient without any malignancy or risk factors, the typical ultrasound features of a cavernous haemagioma requires no follow up.