Fig. 4

Pathologically proven cHCC-CC tumor demonstrating both washout and progression: a-c is the superior aspect of the tumor and d-f is the more inferior aspect of the tumor. The superior portion of the tumor is T2 intermediate (a) and shows show arterial hyperenhancement and washout (b, c), typical of HCC. However the more inferior component of the tumor has some internal T2 hypointense components (d), and relatively hypovascular on the arterial phase (e) and shows some progression of enhancement on the delayed phase (f). The presence of washout and progression in the same lesion should alert the radiologist to the possibility of a cHCC-CC tumor