(HealthDay News) — Focal liver lesions (FLLs) are mostly benign, and can be diagnosed based on knowledge of their presentation, associated clinical and laboratory features, and natural history, according to clinical guidelines published online August 19 in the American Journal of Gastroenterology.

Noting that the increasing and widespread use of imaging has led to an increase in FLL detection, Jorge A. Marrero, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues discuss FLL diagnosis and management.

The authors note that FLLs frequently pose a diagnostic challenge for physicians. Most FLLs are benign, but given the broad differential of FLLs, differentiating malignant from benign FLLs may be difficult. Furthermore, some noncancerous lesions have malignant potential. Clinical characteristics such as the patient’s age, gender, use of oral contraceptives, history of chronic liver disease, and recent travel may assist with etiology. Underlying chronic liver disease and the time of detection of the lesion provide insight into the nature and relevance of the lesion. Cyst lesions can be differentiated from solid lesions radiologically. Furthermore, certain solid lesions can be diagnosed precisely by quality imaging modalities. Liver biopsy carries high risk of bleeding and may not add value to radiologic diagnosis in many benign lesions.

“Although malignancy is often the concern with liver masses, most FLLs presenting as ‘incidentalomas’ are benign and require patient reassurance and monitoring,” the authors write.

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