Which of the following is an example of a focal liver lesion?

• A. Diffuse fatty infiltration
• B. Hepatic abscess
• C. Cavernous Hemangioma
• D. Cirrhosis

Answer: (C)

A focal liver lesion is a discrete area of abnormal tissue confined to a specific spot in the liver, rather than affecting the entire organ. Cavernous hemangioma fits this definition as the most common benign focal liver lesion: it is usually a solitary, well-defined mass. Imaging echoes its typical behavior—on ultrasound it’s often well circumscribed and bright, while CT and MRI show a pattern of peripheral nodular enhancement in the arterial phase with progressive fill-in toward the center in later phases; on MRI it appears very bright on T2-weighted images. Clinically, these lesions are commonly asymptomatic and found incidentally.

In contrast, diffuse fatty infiltration and cirrhosis involve the liver as a whole, not a single nodule. A hepatic abscess can be focal, but it represents an infectious process with potential systemic symptoms and different imaging characteristics, such as irregular borders and rim enhancement. The combination of being the classic well-defined focal lesion and having characteristic imaging features makes cavernous hemangioma the best example of a focal liver lesion.