Liver imaging: hepatocellular carcinoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Liver imaging: hepatocellular carcinoma

Sample item

A cirrhotic patient has a 3 cm liver lesion that enhances brightly in the arterial phase and shows washout in the portal venous phase on multiphase CT. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Hepatocellular carcinoma

Arterial phase hyperenhancement with washout in a cirrhotic liver is diagnostic of HCC (LI-RADS 5) without biopsy. Haemangiomas show progressive centripetal fill-in. Raised alpha-fetoprotein supports the diagnosis.

Option by option

  • A. Focal nodular hyperplasia

    FNH enhances homogeneously and has a central scar, and occurs in normal liver.

  • B. Simple cyst

    A cyst does not enhance.

  • C. Haemangioma

    Haemangioma enhances peripherally and fills in, without washout.

  • D. Hepatocellular carcinoma (correct)

    Correct. Arterial enhancement with washout in cirrhosis is diagnostic of HCC.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Hepatocellular carcinoma. Arterial phase hyperenhancement with washout in a cirrhotic liver is diagnostic of HCC (LI-RADS 5) without biopsy.

Why is "Focal nodular hyperplasia" not the answer?

FNH enhances homogeneously and has a central scar, and occurs in normal liver.

Why is "Simple cyst" not the answer?

A cyst does not enhance.

Why is "Haemangioma" not the answer?

Haemangioma enhances peripherally and fills in, without washout.

What concept does this question test?

It tests Liver imaging: hepatocellular carcinoma in Radiology. Haemangiomas show progressive centripetal fill-in. Raised alpha-fetoprotein supports the diagnosis.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Liver imaging: hepatocellular carcinoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.