Primary malignant fibrous histiocytoma of the liver: CT findings in five histopathological proven patients

To describe imaging features of primary hepatic malignant fibrous histiocytoma (MFH), especially its dynamic enhancement pattern.

The CT manifestations of five patients with histopathological proven primary hepatic MFH retrospectively reviewed.

Six hepatic masses were detected in the five patients at CT examinations. All tumors were hypodense on plain CT scanning related to adjacent hepatic parenchyma. Five lesions were heterogeneous with predominantly cystic or necrosis areas and one lesion was homogeneous solid. After administration of contrast material, solid components of the four tumors with cystic or necrotic areas and the solid lesion showed a “fast rushing in and washing out” enhancement pattern with marked enhancement at the arterial dominated phase and fast decreasing at the portal vein dominated phase and the delay phase. The remaining one tumor showed slight enhancement of its solid components. Portal lymph node enlargement was observed in one patient and the inferior vena cava was invaded in one patient, respectively.

The CT manifestations of primary hepatic MFH are various and nonspecific. A “fast rushing in and washing out” enhancement pattern of MFH in our series has not been reported before. These manifestations could help radiologists to include primary hepatic MFH in the differential diagnosis list.