若杉 聡¹, 大栗 茂芳¹, 平田 信人¹, 船津 康裕¹, 関山 和彦¹, 与芝 真¹, 藤田 力也¹, 菊地 浩彰², 緑川 武正², 熊田 馨², 大橋 真由美³, 大渕 真男⁴, 國安 芳夫⁴

Satoshi WAKASUGI¹, Shigeyosi OOGURI¹, Nobuto HIROTA¹, Yasuhiro FUNATSU¹, Kazuhiko SEKIYAMA¹, Makoto YOSHIBA¹, Rikiya FUJITA¹, Hiroaki KIKUCHI², Takemasa MIDORIKAWA², Kaoru KUMADA², Mayumi OOHASHI³, Masao OOBUCHI⁴, Yosio KUNIYASU⁴

¹昭和大学藤が丘病院消化器内科, ²昭和大学藤が丘病院外科, ³昭和大学藤が丘病院超音波センター, ⁴昭和大学藤が丘病院放射線科

¹Division of Gastroenterobgy Department of Internal Medicine, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-0043 Japan, ²Department of surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-0043 Japan, ³Ultrasonography Center, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-0043 Japan, ⁴Department of Radiology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-0043 Japan

キーワード : Double capsular sign, Extrahepatic growing hepatocellular carcinoma, Hump sign, Ultrasonography

Ultrasonography showed double high-echoic lines around an extrahepatic hepatocellular carcinoma diagnosed in a 77-years-old woman. The mechanism of this observation is assumed to be explained by the high echo derived from the liver capsule surrounding the tumor, which was compressed into liver parenchyma by the diaphragma or inner abdominal wall. Because such double lines are ususual in cases liver tumors located in deep liver parenchyma, the sign seems important in diagnosing extrahepatic hepatocellular carcinoma. We propose the term double capsular sign for this specific and important ultrasonographic finding.