Vnitr Lek 1997, 43(3):162-166

[The clinical picture and diagnosis of liver tumors].

M Kaláb: I. interní klinika 1. LF UKa VFN, Praha.

In the diagnosis of hepatic tumour it is most important to differentiate primary carcinoma of the liver from secondary metastatic tumours and focal and infiltrative changes. Primary hepatocellular carcinoma is usually a complication of cirrhosis of the liver. The clinical symptoms therefore correspond especially to an accentuation of the symptomatology of cirrhosis of the liver and complications. The diagnosis is based above all on modern imaging methods such as ultrasonography, computed tomography, nuclear magnetic resonance, examination of tumour markers. Examination by needle biopsy is important and is nowadays usually done under ultrasonographic control to obtain material for histological or cytological examination. Secondary metastases into the liver usually associated with tumours of the pancreas, colon, stomach, bronchi. A frequent diagnostic problem is the recognition of some cysts, capillary, haemangiomas, focal steatosis and focal nodular hyperplasia. An abscess of the liver can also cause differential diagnostic problems. The marked advances in the diagnosis of hepatic tumours are unfortunately not always followed by therapeutic success.