American Board of Surgery Qualifying Exam (ABS QE) Practice Test

How does a hepatic adenoma typically appear on imaging?

1. Isointense and heterogeneous

2. Hypoattenuating

3. Isointense and homogeneous

4. Hyperattenuating

The correct answer is: Isointense and homogeneous

A hepatic adenoma typically appears on imaging as iso-intense and homogeneous due to the nature of its cellular composition and vascular characteristics. These tumors are benign liver masses that are primarily composed of hepatocytes arranged in a structure similar to normal liver tissue. This similarity allows them to often have the same attenuation values as healthy liver tissue on CT scans, resulting in an iso-intense appearance. The homogeneous nature refers to how the adenoma does not usually have cystic components or significant cellular atypia, contributing to a more uniform appearance on imaging. In most cases, when contrasted with surrounding liver tissue, adeomas may not show significant differences, further supporting the iso-intense characteristic in imaging studies. Considering the other options, while some benign liver lesions may exhibit heterogeneous patterns due to internal bleeding or necrosis, hepatic adenomas typically remain homogeneous. Similarly, while some masses can be hypoattenuating or hyperattenuating relative to the surrounding liver, hepatic adenomas do not typically present with these features. Thus, the correct description aligns with the common appearance of hepatic adenomas in diagnostic imaging.