Question:medium
A 22 year old man presents with a solitary 2 cm space occupying lesion of mixed echogenicity in the right lobe of the liver on ultrasound. The rest of the liver is normal. Which of the following tests should be done?
A 22 year old man presents with a solitary 2 cm space occupying lesion of mixed echogenicity in the right lobe of the liver on ultrasound. The rest of the liver is normal. Which of the following tests should be done?
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A young patient with a solitary liver mass in an otherwise normal liver needs non-invasive characterization by contrast CT before any biopsy is considered.
Updated On: Jul 8, 2026
- Ultrasound guided biopsy of the lesion
- Hepatic scintigraphy
- Hepatic angiography
- Contrast enhanced CT scan of the liver
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Picture the clinical scene.
A healthy young man is found to have one small liver lesion by chance on ultrasound, with the rest of the liver looking normal. This pattern usually points toward a benign growth rather than cancer.
Step 2: Ask what test settles the diagnosis safely.
The safest and most informative next step is a scan that shows how the lesion takes up contrast dye over time, since hemangiomas, focal nodular hyperplasia, and adenomas each light up in a distinctive way on a contrast enhanced CT.
Step 3: See why the other tests fall short.
A biopsy carries a real risk of bleeding if the mass turns out to be a vascular benign tumor, so it is held back until imaging is inconclusive. Scintigraphy only gives supporting evidence for one type of lesion and misses fine detail. Angiography is invasive and has largely been replaced by CT for this purpose.
Step 4: Conclude.
The correct next test is a contrast enhanced CT scan of the liver.
$\boxed{\text{Contrast enhanced CT scan of the liver}}$
A healthy young man is found to have one small liver lesion by chance on ultrasound, with the rest of the liver looking normal. This pattern usually points toward a benign growth rather than cancer.
Step 2: Ask what test settles the diagnosis safely.
The safest and most informative next step is a scan that shows how the lesion takes up contrast dye over time, since hemangiomas, focal nodular hyperplasia, and adenomas each light up in a distinctive way on a contrast enhanced CT.
Step 3: See why the other tests fall short.
A biopsy carries a real risk of bleeding if the mass turns out to be a vascular benign tumor, so it is held back until imaging is inconclusive. Scintigraphy only gives supporting evidence for one type of lesion and misses fine detail. Angiography is invasive and has largely been replaced by CT for this purpose.
Step 4: Conclude.
The correct next test is a contrast enhanced CT scan of the liver.
$\boxed{\text{Contrast enhanced CT scan of the liver}}$
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