Which benign lesion is associated with tuberous sclerosis and may show a propagation speed artifact known as 'broken diaphragm' on ultrasound?

Which benign lesion is associated with tuberous sclerosis and may show a propagation speed artifact known as 'broken diaphragm' on ultrasound?

• A. Hepatic Lipoma
• B. Liver Cell Adenoma
• C. Hemangioma
• D. Fibrolamellar carcinoma

Answer: (A)

Tuberous sclerosis predisposes to fat-containing hamartomatous liver lesions, and the broken diaphragm propagation speed artifact on ultrasound points to a fat-rich lesion. Hepatic lipoma is a benign lesion composed of fat, so its fat content creates a propagation speed artifact that can make the diaphragmatic line appear interrupted—the broken diaphragm sign. Other listed lesions are not characteristically linked to tuberous sclerosis and do not typically show this specific artifact. Hemangioma, liver cell adenoma, and fibrolamellar carcinoma have different imaging features and etiologies, and they don’t commonly present with the fat-related broken diaphragm sign. Thus hepatic lipoma best fits the combination of tuberous sclerosis association and the characteristic ultrasound artifact.

Tuberous sclerosis predisposes to fat-containing hamartomatous liver lesions, and the broken diaphragm propagation speed artifact on ultrasound points to a fat-rich lesion. Hepatic lipoma is a benign lesion composed of fat, so its fat content creates a propagation speed artifact that can make the diaphragmatic line appear interrupted—the broken diaphragm sign.

Other listed lesions are not characteristically linked to tuberous sclerosis and do not typically show this specific artifact. Hemangioma, liver cell adenoma, and fibrolamellar carcinoma have different imaging features and etiologies, and they don’t commonly present with the fat-related broken diaphragm sign.

Thus hepatic lipoma best fits the combination of tuberous sclerosis association and the characteristic ultrasound artifact.