What are the diagnostic approaches for liver space-occupying lesions?
Dec 03, 2025
Source: Cainiu Health
Dr. Huang Yuhong
Introduction
The diagnostic approach to liver space-occupying lesions generally includes analysis of medical history and symptoms, evaluation of imaging studies, tumor marker testing, pathological diagnosis via biopsy, and comprehensive assessment of laboratory indicators. Inquire about the patient's history of hepatitis or cirrhosis, and assess recent changes in body weight, loss of appetite, jaundice, and other symptoms. Hepatic region pain, fever, or an abdominal mass may suggest malignant disease.
The diagnostic approach to liver space-occupying lesions generally includes analysis of medical history and symptoms, evaluation of imaging studies, tumor marker testing, pathological diagnosis via biopsy, and comprehensive assessment of laboratory indicators. The specific analysis is as follows:
1. Medical history and symptom analysis: Inquire about the patient’s prior history of hepatitis or cirrhosis, and assess recent changes in body weight, appetite, presence of jaundice, etc. Liver area pain, fever, or an abdominal mass may suggest malignant disease, while sudden severe abdominal pain should raise concern for rupture and hemorrhage of the lesion.
2. Imaging evaluation: Ultrasound can initially determine the location, size, and margins of the lesion. Contrast-enhanced CT scans reveal blood supply characteristics, while MRI offers higher soft-tissue resolution and is particularly useful in differentiating hemangiomas from hepatocellular carcinoma. Multi-modal imaging analysis improves diagnostic accuracy.
3. Tumor marker testing: Elevated alpha-fetoprotein (AFP) is commonly seen in primary hepatocellular carcinoma; abnormal carcinoembryonic antigen (CEA) levels may indicate metastatic tumors; increased carbohydrate antigen 19-9 (CA19-9) warrants consideration of cholangiocarcinoma. Trends in tumor markers should be dynamically monitored in conjunction with imaging findings.
4. Pathological diagnosis via biopsy: Under image guidance, tissue samples are obtained to definitively determine the nature of the lesion. This is the gold standard for diagnosis, but strict indications must be followed to avoid risks such as tumor seeding or bleeding, especially in patients with coagulopathy.
5. Comprehensive laboratory assessment: Indicators such as severity of liver function abnormalities, white blood cell count and differential in complete blood count, and coagulation profiles help determine whether the lesion is complicated by infection, cirrhosis, or liver failure.
After detection of a liver space-occupying lesion, patients should avoid strenuous physical activity to prevent rupture. Prompt referral to a hepatobiliary specialty clinic is recommended for further evaluation to clarify the underlying cause, formulation of a treatment plan under medical guidance, and regular follow-up to monitor disease progression.
