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Zhao R, Guo C, Zhang X, Kong L. A child with Hepatic Focal Nodular Hyperplasia: A rare case report. Asian J Surg 2022; 45:2107-2108. [PMID: 35570107 DOI: 10.1016/j.asjsur.2022.04.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Rongnan Zhao
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, 256603, People's Republic of China
| | - Chenglong Guo
- Department of Health Examination, Binzhou Medical University Hospital, Binzhou, Shandong Province, 256603, People's Republic of China
| | - Xingyuan Zhang
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, 256603, People's Republic of China
| | - Lingqun Kong
- Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou City, Shandong Province, 256603, People's Republic of China.
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Busireddy KK, Ramalho M, AlObaidy M, Matos AP, Burke LM, Dale BM, Semelka RC. Multiple focal nodular hyperplasia: MRI features. Clin Imaging 2017; 49:89-96. [PMID: 29190518 DOI: 10.1016/j.clinimag.2017.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE To describe MRI features of multiple Focal Nodular Hyperplasia (FNHs). METHODS 40 consecutive subjects (37 females, mean age, 38.8years) were included. All studies were independently reviewed. This was an observational study to define the radiological features of multifocal FNH. RESULTS 130 lesions were evaluated. The majority (88.5%), were peripheral in location. 92.3% lesions were lobulated. Marked enhancement was present in 94.6% lesions. In the portal venous and delayed phase, 46.2% and 47.7% lesions were mildly hyperintense. Central scar was present in 77% lesions. CONCLUSIONS Distinctive features included predominant subcapsular location and mild hyperintensity in the delayed phase, seen in nearly 50% of FNHs.
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Affiliation(s)
- Kiran K Busireddy
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - Miguel Ramalho
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal
| | - Mamdoh AlObaidy
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA; Department of Radiology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - António P Matos
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal
| | - Lauren M Burke
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - Brian M Dale
- MR Research and Development, Siemens Medical Solutions, Morrisville, NC, USA
| | - Richard C Semelka
- Department of Radiology, University of North Carolina at Chapel Hill, NC, USA.
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Amisaki M, Honjo S, Iida N, Kuwamoto S, Fujiwara Y. Focal nodular hyperplasia that mimicked a liver metastasis from a soft tissue sarcoma: a case report. Surg Case Rep 2017; 3:59. [PMID: 28455622 PMCID: PMC5409908 DOI: 10.1186/s40792-017-0332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background Imaging modalities (computed tomography (CT), ultrasonography, and magnetic resonance imaging (MRI)) have only limited ability to distinguish liver focal nodular hyperplasia (FNH) from metastatic liver tumors. Here, we report a patient who underwent surgery for benign FNH that mimicked a liver metastasis from soft tissue sarcoma (STS). Case presentation A 23-year-old man with a history of several surgeries for metastatic abdominal STS, developed a hepatic tumor accompanying peritoneal STS recurrence. He was diagnosed with a metastatic liver tumor from the STS, based on imaging studies for the hepatic tumor that showed a growing hypervascular lesion and hypo-intensity in hepatic phase on dynamic CT and MRI. However, when the liver and peritoneal tumors were resected, histological diagnosis showed the hepatic tumor to be benign liver FNH. Conclusions Although FNH should be considered as a differential diagnosis for hypervascular hepatic tumors, it has few typical findings, and its appropriate management is controversial. A lesion strongly suspected of being a metastatic liver tumor might require surgical resection.
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Affiliation(s)
- Masataka Amisaki
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Soichiro Honjo
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan.
| | - Noriyuki Iida
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Satoshi Kuwamoto
- Division of Molecular Pathology, Department of Pathology, Tottori University Hospital, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
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4
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Chung E, Park CH, Kim J, Han NI, Lee YS, Choi HJ, Bae SH, Park IY. [Recurrence of multiple focal nodular hyperplasia in a young male patient]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2014; 64:49-53. [PMID: 25073672 DOI: 10.4166/kjg.2014.64.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor that is usually found in women. Diagnosis of FNH mainly depends on imaging studies such as color Doppler flow imaging, computed tomography, and magnetic resonance imaging. It is characterized by the presence of stellate central scar and is nowadays incidentally diagnosed with increasing frequency due to advances in radiologic imaging technique. FNH typically presents as a single lesion in 70% of cases and generally does not progress to malignancy or recur after resection. Herein, we report a case of a young male patient with recurrent multiple FNH who underwent surgical resection for presumed hepatic adenoma on computed tomography.
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Affiliation(s)
- Eun Chung
- Department of General Surgery, The Catholic University of Korea, Bucheon St. Mary's Hospital, 327 Sosa-ro, Wonmi-gu, Bucheon 420-717, Korea
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5
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Focal nodular hyperplasia and hepatic adenoma: current diagnosis and management. Updates Surg 2013; 66:9-21. [DOI: 10.1007/s13304-013-0222-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/16/2013] [Indexed: 12/25/2022]
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6
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Focal nodular hyperplasia--a review of myths and truths. J Gastrointest Surg 2011; 15:2275-83. [PMID: 21959783 DOI: 10.1007/s11605-011-1680-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Accepted: 09/07/2011] [Indexed: 01/31/2023]
Abstract
BACKGROUND Focal nodular hyperplasia (FNH) is a benign hyperplastic lesion of the liver with no known malignant potential. It has generated much interest due to the frequency with which it presents with atypical features on radiological imaging. Often resulting in misdiagnosis. Moreover, the understanding of particular subtypes of this lesion at a molecular level has changed in recent years. This may have implications on how certain subtypes should be managed. PURPOSE This review aims to analyse current literature pertaining to FNH and to provide clinically relevant advice regarding diagnosis and management.
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7
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Dual time point C-11 acetate PET imaging can potentially distinguish focal nodular hyperplasia from primary hepatocellular carcinoma. Clin Nucl Med 2010; 34:874-7. [PMID: 20139820 DOI: 10.1097/rlu.0b013e3181bed06e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
C-11 acetate positron emission tomography (PET) is known to have high sensitivity in detecting hepatocellular carcinoma. However, one of the shortcomings of C-11 acetate PET in the diagnosis of hepatocellular carcinoma is that C-11 acetate also accumulates in focal nodular hyperplasia, which makes it challenging to distinguish hepatocellular carcinoma form focal nodular hyperplasia when a conventional single time point PET imaging method is used. Two patients with suspected hepatocellular carcinoma and negative fluoro-deoxy-glucose PET scans underwent C-11 acetate PET dual time imaging in which both early and delayed images were acquired. One patient was subsequently confirmed having hepatocellular carcinoma while the other had focal nodular hyperplasia. C-11 acetate imaging was positive in both patients. Interestingly, in hepatocellular carcinoma the C-11 acetate activity in the delayed images is higher than in the early images while in focal nodular hyperplasia, the C-11 acetate activity decreased in the delayed image when compared with early images. Our findings suggest that dual time point imaging has potential to improve the diagnostic accuracy of C-11 acetate PET in the diagnosis of hepatocellular carcinoma.
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Kamaya A, Maturen KE, Tye GA, Liu YI, Parti NN, Desser TS. Hypervascular Liver Lesions. Semin Ultrasound CT MR 2009; 30:387-407. [DOI: 10.1053/j.sult.2009.06.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Citak EC, Karadeniz C, Oguz A, Boyunaga O, Ekinci O, Okur V. Nodular regenerative hyperplasia and focal nodular hyperplasia of the liver mimicking hepatic metastasis in children with solid tumors and a review of literature. Pediatr Hematol Oncol 2007; 24:281-9. [PMID: 17613871 DOI: 10.1080/08880010701441229] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Nodular regenerative hyperplasia (NRH) and focal nodular hyperplasia (FNH) of the liver rarely occur in children after completion of tumor therapy. These lesions mimic hepatic metastasis and they must be distinguished from metastatic lesions. The authors present 2 children, one with NRH and one with FNH, after undergoing antineoplastic therapy for non-hepatic childhood solid tumors and discuss their patients in the context of the literature.
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Affiliation(s)
- Elvan Caglar Citak
- Department of Pediatric Oncology, Gazi University Faculty of Medicine, Ankara, Turkey. caglarcitak@ yahoo.com
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Petsas T, Tsamandas A, Tsota I, Karavias D, Karatza C, Vassiliou V, Kardamakis D. A case of hepatocellular carcinoma arising within large focal nodular hyperplasia with review of the literature. World J Gastroenterol 2006; 12:6567-71. [PMID: 17072995 PMCID: PMC4100652 DOI: 10.3748/wjg.v12.i40.6567] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Focal nodular hyperplasia (FNH) is a relatively rare benign hepatic tumor, usually presenting as a solitary lesion; however, multiple localizations have also been described. The association of FNH with other hepatic lesions, such as adenomas and haemangiomas has been reported by various authors. We herein report a case of a hepatocellular carcinoma arising within a large focal nodular hyperplasia, in a young female patient.
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Affiliation(s)
- Theodoros Petsas
- Department of Radiology, University of Patras Medical School, 26500 Rion, Greece
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Langrehr JM, Pfitzmann R, Hermann M, Radke C, Neuhaus P, Pech M, Denecke T, Felix R, Hänninen EL. Hepatocellular carcinoma in association with hepatic focal nodular hyperplasia. Acta Radiol 2006; 47:340-4. [PMID: 16739692 DOI: 10.1080/02841850600570474] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To report the association between hepatocellular carcinoma (HCC) and hepatic focal nodular hyperplasia (FNH) and the possible impact on clinical decision-making with regard to resective approaches in patients with FNH. MATERIAL AND METHODS We retrospectively analyzed the findings in 77 adult patients who underwent liver resections for FNH between October 1989 and September 2001 at our center. HCC within the confines of FNH was found in two patients. We demonstrate the magnetic resonance imaging (MRI) and macroscopic and microscopic findings. RESULTS Presurgical MRI demonstrated heterogeneous signal characteristics of moderately hyperintense FNH on T2-weighted images and, after i.v. administration of superparamagnetic iron oxide particles, HCC in FNH was barely delineable. Both patients underwent successful right hemihepatectomy to remove the suspicious FNH with diameters of 12 and 14 cm; intralesional HCC diameters were 3 and 5 cm, respectively. Patients could be rapidly dismissed. However, one patient died after recurrence of HCC 1.5 years after surgery, whereas the other patient continues tumor-free 4 years after surgery. Alpha-feto-protein was normal in both patients. CONCLUSION In FNH with rapid growth tendency and heterogenic MR appearance, surgical removal should be considered to overcome the risk of inadequate therapy in the very rare group of patients with HCC in association with FNH.
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Affiliation(s)
- J M Langrehr
- Department of General, Visceral and Transplantation Surgery, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany.
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Vilgrain V. Focal nodular hyperplasia. Eur J Radiol 2006; 58:236-45. [PMID: 16414229 DOI: 10.1016/j.ejrad.2005.11.043] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/25/2005] [Accepted: 11/29/2005] [Indexed: 01/06/2023]
Abstract
Focal nodular hyperplasia is the second most common benign liver tumor after hemangioma and occurs predominantly in young women. Imaging techniques are crucial in the diagnosis of this lesion. In this article, we will present the imaging findings of the classic and non-classic FNHs. The role of percutaneous biopsy will also be detailed.
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Affiliation(s)
- Valérie Vilgrain
- Department of Radiology, Hôpital Beaujon, 100 Bd du Général Leclerc, 92110 Clichy, France.
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Buscarini E, Danesino C, Plauchu H, de Fazio C, Olivieri C, Brambilla G, Menozzi F, Reduzzi L, Blotta P, Gazzaniga P, Pagella F, Grosso M, Pongiglione G, Cappiello J, Zambelli A. High prevalence of hepatic focal nodular hyperplasia in subjects with hereditary hemorrhagic telangiectasia. ULTRASOUND IN MEDICINE & BIOLOGY 2004; 30:1089-1097. [PMID: 15550313 DOI: 10.1016/j.ultrasmedbio.2004.08.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2004] [Revised: 07/31/2004] [Accepted: 08/05/2004] [Indexed: 05/24/2023]
Abstract
A vascular pathogenesis of hepatic focal nodular hyperplasia (FNH) has been suggested; this study was aimed to evaluate in families with hereditary hemorrhagic telangiectasia (HHT) the prevalence of FNH, relating it to presence and stage of hepatic vascular malformations (VMs). Fifty-two HHT families underwent a screening program including abdominal Doppler sonography (US) searching for hepatic VMs; we classified them as minimal, moderate and severe, depending on the number and degree of abnormalities found by Doppler US. Presence of focal liver lesions was recorded. Diagnosis of FNH was made if at least two examinations, whether color Doppler US, liver scintigraphy, dynamic computed tomography (CT) or magnetic resonance (MR), showed suggestive findings. FNH was found in five out of 274 subjects (1.8%). All five were affected by HHT. Thus, percentage related to the group of affected patients increased to 2.9; 4/5 presented severe liver VMs. Female-to-male ratio was 4:1. FNH was single in three cases; tumor size ranged between 20 and 90 mm. During follow-up, no lesion showed a reduction in size, three showed an increase. Prevalence of FNH in patients with HHT is far greater than that reported in the general population; Doppler US role in its diagnosis and follow-up is highlighted.
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Ba-Ssalamah A, Schima W, Schmook MT, Linnau KF, Schibany N, Helbich T, Reimer P, Laengle F, Wrba F, Kurtaran A, Ryan M, Mann FA. Atypical focal nodular hyperplasia of the liver: imaging features of nonspecific and liver-specific MR contrast agents. AJR Am J Roentgenol 2002; 179:1447-56. [PMID: 12438034 DOI: 10.2214/ajr.179.6.1791447] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The objective of our study was to describe the functional and differential uptake features of atypical focal nodular hyperplasia using different MR contrast agents and to evaluate their potential role in the diagnosis and characterization of focal nodular hyperplasia. MATERIALS AND METHODS Contrast-enhanced MR images of 45 patients with 85 focal nodular hyperplasia lesions were retrospectively reviewed. In these patients, sonographic findings were nonspecific (n = 37), or CT features were inconclusive (n = 8). Non-liver specific gadolinium chelates were used in 18 patients (48 lesions) suspected of having either focal nodular hyperplasia or hemangioma. The following liver-specific agents were used in patients with suspected focal nodular hyperplasia or metastases: mangafodipir trisodium, 30 patients (55 lesions); ferumoxides, six patients (16 lesions); and SHU 555 A, six patients (six lesions). Individual lesions were quantified by signal intensity and assessed qualitatively by homogeneity, contrast enhancement, and presence of a central scar. RESULTS At unenhanced MR imaging, the triad of homogeneity, isointensity, and central scar was found in 22% of the focal nodular hyperplasia lesions. On mangafodipir trisodium-enhanced T1-weighted images, all focal nodular hyperplasia lesions showed contrast uptake: in 64% of the lesions, uptake was equal to parenchyma; 25%, greater than the parenchyma; and 11%, less than the parenchyma. On iron oxide-enhanced T2-weighted images, all focal nodular hyperplasia lesions showed uptake of the contrast agent, but contrast uptake in the lesions was less than in the surrounding parenchyma. Dynamic gadolinium chelate-enhanced MR imaging showed early and vigorous enhancement of focal nodular hyperplasia lesions with rapid washout in 88%. Atypical imaging features of the lesions included hyperintensity on T1-weighted images, necrosis and hemorrhage, and inhomogeneous or only minimal contrast uptake. CONCLUSION For patients in whom the diagnosis of focal nodular hyperplasia cannot be established on unenhanced or gadolinium-enhanced MR imaging, homogeneous uptake of liver-specific contrast agent with better delineation of central scar may help to make a confident diagnosis of focal nodular hyperplasia.
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Affiliation(s)
- Ahmed Ba-Ssalamah
- Department of Radiology, University of Vienna, Waehringer Gürtel 18-20, A-1090 Vienna, Austria
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Brancatelli G, Federle MP, Grazioli L, Blachar A, Peterson MS, Thaete L. Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology 2001; 219:61-8. [PMID: 11274535 DOI: 10.1148/radiology.219.1.r01ap0361] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate features of focal nodular hyperplasia (FNH) at multiphasic helical computed tomography (CT). MATERIALS AND METHODS Clinical, pathologic, and preoperative imaging findings were retrospectively reviewed in 78 patients. Conventional liver CT was performed in nine patients; helical multiphasic CT, in 69. Diagnosis was based on complete resection (n = 20), biopsy (n = 42), or clinical and imaging follow-up for a minimum of 6 months (n = 16). Number, size, location, margins, surface, homogeneity of enhancement, and presence of a central scar, mass effect, exophytic growth, calcification, pseudocapsule, or vessels feeding or draining the lesion were evaluated. RESULTS CT depicted 124 tumors (mean diameter, 4.1 cm; range, 1-11 cm); 62 were small (< or =3 cm). FNHs were hypervascular and hyperattenuating to liver on 106 of 106 arterial phase scans and were isoattenuating to liver on 82 of 89 delayed scans. Of the 124 tumors, 111 enhanced homogeneously, 109 had a smooth surface, 101 were subcapsular, 89 had ill-defined margins, and 62 had a central scar that was observed more often in large lesions (40 of 62 lesions) than in small lesions (22 of 62 lesions). FNHs less frequently exerted a mass effect (43 lesions), had vessels around or within the lesion (42 lesions), demonstrated exophytic growth (40 lesions), or showed a pseudocapsule (10 lesions). Only one FNH had calcification. CONCLUSION Helical CT demonstrates characteristic features that may allow confident diagnosis of FNH. In typical cases, neither biopsy nor further imaging is necessary.
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Affiliation(s)
- G Brancatelli
- Department of Radiology, University of Pittsburgh Medical Center, Presbyterian Hospital, 200 Lothrop St, Rm 4660 CHP MT, Pittsburgh, PA 15213-2582, USA
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Nishigaki Y, Tomita E, Matsuno Y, Goto K, Ohnishi T, Tanaka Y, Iwai H, Asano H, Yasuda I, Nagura K, Wakahara T, Yamada T. Usefulness of novel imaging modalities in diagnosis of focal nodular hyperplasia of the liver. J Gastroenterol 1997; 32:677-83. [PMID: 9349997 DOI: 10.1007/bf02934121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 17-year-old woman was admitted because of a liver tumor found incidentally by ultrasonography. Liver function was normal and there were no markers of hepatitis viruses or malignancy. Abdominal ultrasonography, computed tomography (CT), and magnetic resonance imaging revealed a mass (2 cm in diameter) in the lateral segment of the left lobe of the liver. The lesion was not detected by hepatic arteriography. However, dynamic CT with fast scanning and dynamic CO2-enhanced ultrasonography demonstrated initial central enhancement of the mass followed by centrifugal spread of enhancement to the periphery. Color Doppler flow imaging detected a central color spot, shown to be an artery by a pulsed Doppler spectrum analysis. Fine-needle biopsy confirmed a diagnosis of focal nodular hyperplasia. Dynamic CT with fast scanning, dynamic CO2-enhanced ultrasonography, and color Doppler flow imaging were useful in detecting the vascular pattern specific to focal nodular hyperplasia. Investigation of further cases with these novel imaging modalities should help to establish a comprehensive diagnostic procedure and thus avoid unnecessary surgery for focal nodular hyperplasia, which is a completely benign lesion.
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Affiliation(s)
- Y Nishigaki
- Department of Gastroenterology, Gifu Municipal Hospital, Japan
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Di Stasi M, Caturelli E, De Sio I, Salmi A, Buscarini E, Buscarini L. Natural history of focal nodular hyperplasia of the liver: an ultrasound study. JOURNAL OF CLINICAL ULTRASOUND : JCU 1996; 24:345-350. [PMID: 8873856 DOI: 10.1002/(sici)1097-0096(199609)24:7<345::aid-jcu3>3.0.co;2-b] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Sixteen cases of focal nodular hyperplasia (FNH) of the liver were followed by ultrasound (US) for a mean of 33 months (range 6-81). In 69% of the cases, the diagnosis was incidental. On US the lesions were single in 75% of the cases, localized in the right lobe in 75%, and subcapsular in 50%. No specific US-pattern could be identified. A central scar was found in 19% of the patients. At the end of the follow-up, the size was reduced in 7/16 cases, and in 1/16 the lesion disappeared. The spontaneous reduction of nodules in FNH must be considered in the management of this pseudotumor.
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Affiliation(s)
- M Di Stasi
- Gastroenterology Unit, Hospital of Piacenza, Italy
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