fig2

Figure 2. Metastasis. 70-year-old female with abdominal ultrasound performed for right upper quadrant pain, query gallstones. Greyscale ultrasound shows a focal hypoechoic mass in the right lobe of the liver (A); at 20 s, the mass is hypoenhanced, appearing very slightly less bright than the liver (B); at 30 s, there is already washout of the mass, so that it is now much less enhanced than the adjacent liver. It is also less enhanced than it was at 20 s (C); at 2 min, the mass appears as a black hole due to marked washout. This rapid transition from enhancement to washout is typical of metastatic disease. Biopsy showed adenocarcinoma, of unknown origin (D)