HTLV-1 Myelopathy — RACP Adult Medicine MCQ
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Correct answer: A — Stage as HCC using the characteristic multiphasic imaging pattern
Explanation lettering: C = shown as A · D = shown as B · B = shown as C · E = shown as D · A = shown as E
C is correct. In an at-risk cirrhotic liver, a lesion over 1 cm with characteristic arterial enhancement and washout can establish HCC non-invasively and should proceed to staging/MDT review. D overvalues AFP. E delays care. A biopsy is reserved for indeterminate imaging or alternative diagnosis. B reverses the significance of washout.
Reference: Medical Journal of Australia, Australian recommendations for management of hepatocellular carcinoma: https://www.mja.com.au/journal/2021/214/10/australian-recommendations-management-hepatocellular-carcinoma-consensus