1. Secondary liver cancer (liver malignancy): Compared with primary liver cancer, secondary liver cancer develops slowly and has milder symptoms. The most common type of secondary liver cancer is gastric cancer, followed by lung, colon, pancreas, breast, etc., which often metastasize to the liver. It often presents as multiple nodular lesions. Alpha-fetoprotein (AFp) tests are generally negative, except for a few cases where the primary cancer is in the digestive tract. 2. Liver cirrhosis: Liver cancer often occurs on the basis of liver cirrhosis, and it is often difficult to distinguish between the two. Differentiation depends on a detailed medical history, physical examination and laboratory tests. Liver cirrhosis develops slowly and has recurrences, with more significant liver damage. A positive serum alpha-fetoprotein (AFp) often indicates cancer. 3. Active liver disease: The following points can help differentiate liver cancer from active liver disease (acute or chronic hepatitis). AFp alpha-fetoprotein test and SGpT alanine aminotransferase must be tested at the same time. 4. Liver abscess: Symptoms include fever, pain in the liver area, and symptoms of inflammation and infection. The white blood cell count is often elevated, there is obvious percussion pain and tenderness in the liver area, tension in the left upper abdominal muscles, and edema of the surrounding chest wall. 5. Hepatic cavernous hemangioma: This disease is a benign space-occupying lesion in the liver, which is often discovered accidentally during physical examination, such as B-mode ultrasound or radionuclide scanning. This disease is common in my country. Differential diagnosis mainly relies on alpha-fetoprotein determination, B-mode ultrasound and hepatic angiography. 6. Hepatic echinococcosis: The patient has progressive enlargement of the liver, which is hard and nodular in texture. In the late stage, most of the liver is destroyed, and the clinical manifestations are very similar to primary liver cancer. 7. Extrahepatic tumors adjacent to the liver: such as gastric cancer, upper abdominal high retroperitoneal tumors, kidney, adrenal gland, colon, pancreatic cancer and retroperitoneal tumors are easily confused with primary liver cancer. In addition to the fact that alpha-fetoprotein is mostly negative, which can help to distinguish, different medical history and clinical manifestations, especially ultrasound, CT, MRI and other imaging examinations, gastrointestinal X-ray examinations, etc. can all make differential diagnosis. |
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