Focal nodular hyperplasia (FNH) is a rare, benign hepatic tumor which was usually discovered incidentally by imaging procedure performed for some other reasons. FNH is typically asymptomatic and, it seldom bleeds. There is no evidence to support any relation with primary liver cancer. Accordingly, the preferred management is conservative, and excision is reserved for large symptomatic and complicated lesion, or when the diagnosis remains uncertain. Although many cases of FNH has been described to date in the other countries, only four cases of FNH has been reported in Korean literature. In the present report we describe a 7 cm sized asymptomatic lesion of FNH in a 23-year-old woman, that was disclosed by various kinds of imaging procedure. The left lateral segmentectomy was performed. The mass was firm and showed areas of localized growth of mature hepatocytes and septal fibrosis accompanied with marginal ductal proliferation, consistent with FNH. It also displayed an incomplete stellate architectual configration consisted of a central fibrous scar.
Cicatrix ; Diagnosis ; Female ; Fibrosis ; Focal Nodular Hyperplasia* ; Hepatocytes ; Humans ; Liver Neoplasms ; Liver* ; Mastectomy, Segmental ; Young Adult

PURPOSE: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its diagnosis and treatment. METHODS: Eleven patients with FNH treated from January 1997 to January 2007 were analyzed. The clinical findings of pathologically proven FNH were retrospectively reviewed. RESULTS: Among the eleven patients with 18 masses, the mean age was 29.5 (11~57) and the gender ratio (male:female) was 4:7. Four patients had clinical symptoms. Six patients had a solitary mass and five had multiple masses. The mean tumor diameter was 2.73 +/- 1.82 cm. The overall rate of a correct preoperative diagnosis was 0% (0/4) by ultrasound, 36.3% (4/11) by CT and 20.0% (2/10) by MRI. Only two patients had a central stellate scar in the mass. All patients underwent hepatic resection without complication. CONCLUSION: The results of this study showed that the combination of Dynamic CT and dual contrast MRI are important diagnostic methods for FNH. However, a definite preoperative diagnosis of FNH, without a central stellate scar, is very difficult. Surgical resection is recommended for patients with an uncertain diagnosis or clinical symptoms.
Cicatrix ; Diagnosis ; Focal Nodular Hyperplasia* ; Humans ; Liver* ; Magnetic Resonance Imaging ; Retrospective Studies ; Ultrasonography

Focal nodular hyperplvasia (FNH) is a rare benign hepatic tumor that likely represents a local hyperplastic response of hepatocytes to a congenital vascular anomaly. FNH is typically asymtomatic and has a benign course. Hepatic resection is performed when the lesions are large, symptomatic and complicated or when the diagnosis remains uncertain. Although many cases of FNH in children have been described to date in other countries, only one Korean case of multiple FNH has been reported on English literature. We recently experienced a rare case of multiple FNH in a 10-year-old boy, that was confirmed by right inferior subsegmentectomy, left lateral segmentectomy and left medial tumorectomy. We report this case with brief review of literature.
Child ; Diagnosis ; Focal Nodular Hyperplasia* ; Hepatocytes ; Humans ; Liver* ; Male ; Mastectomy, Segmental

Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

Distinction of hepatocellular carcinoma from benign entities such as focal nodular hyperplasia is important because failure of prompt diagnosis could result in a missed opportunity for curative resection. The differential deagnosis, especially among focal nodular hyperplasia and adenoma and even hepatocellualr carcinoma, may have difficult; and when using inly a single imaging method, the diagnosis is often equivocal. Therefore, a combination of imaging modalities is preferred. For focal nodular hyperplasia, the combination of computerized tomography (CT ), magnetic resonance imaging (MRI), and radionuclide scintigraphy showed a high sensitivity and specificity. But, histologic examination is required for the differential diagnos is of hepatic mass. We report a case of hepatocellular carcinoma without clinical evidence of malignancy or serum elevation of tumor marker, that mimicked the CT , MRI, and radionuclide scint igraphic appearance of focal nodular hyperplasia.
Adenoma ; Carcinoma, Hepatocellular* ; Diagnosis ; Focal Nodular Hyperplasia* ; Magnetic Resonance Imaging ; Radionuclide Imaging ; Sensitivity and Specificity

Differential diagnoses of hepatic nodules include hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenoma, regenerative nodule, focal fatty changes, and hemangioma. However, differentiation of these nodules can often be difficult. Hemangiomas are frequently encountered during ultrasonogram incidentally and can be diagnosed easily because they have an almost distinctive sonographic appearance: a homogeneous hyperechogenicity and discrete posterior acoustic enhancement. They also sometimes have atypical findings, for example an internal echogenicity including hypoechogenicity, heterogeneous echogenicity, hyperechoic rim, central hypoechogenicity due to various changes (e.g., internal hemorrhage, necrosis, thrombosis, myxomatous change, and fibrosis), and (rarely) calcification. We report herein the case of an atypical hemangioma presenting with a hypoechoic peripheral ring, mimicking a hepatic malignancy. To our knowledge, there have been no other reports demonstrating a cavernous hemangioma with a discrete hypoechoic ring and without a pseudocapsule.
Acoustics ; Adenoma ; Carcinoma, Hepatocellular ; Caves ; Diagnosis, Differential ; Focal Nodular Hyperplasia ; Hemangioma ; Hemangioma, Cavernous ; Hemorrhage ; Necrosis ; Thrombosis

Gadoxetic acid, a hepatocyte-specific magnetic resonance imaging (MRI) contrast agent, has emerged as an important tool for hepatocellular carcinoma (HCC) diagnosis. Gadoxetic acid-enhanced MRI is useful for the evaluation of early-stage HCC, diagnosis of HCC precursor lesions, and highly sensitive diagnosis of HCC. Furthermore, functional information provided by gadoxetic acid-enhanced MRI can aid in the characterization of focal liver lesions. For example, whereas lesions lack functioning hepatocytes appear hypointense in the hepatobiliary phase, preserved or enhanced expression of organic anion transporting polypeptides in some HCCs as well as focal nodular hyperplasia lead to hyperintensity in the hepatobiliary phase; and a targetoid appearance on transitional phase or hepatobiliary phase imaging can be helpful for identifying the histopathological composition of tumors. While gadoxetic acid-enhanced MRI may improve the sensitivity of HCC diagnosis and provide new insights into the characterization of focal liver lesions, there are many challenges associated with its use. This article reviews the pros and cons of HCC diagnosis with gadoxetic acid-enhanced MRI and discuss some clues in the radiological differentiation of HCC from HCC mimickers.
Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Liver ; Liver Neoplasms ; Magnetic Resonance Imaging ; Peptides

Nodular regenerative hyperplasia (NRH) of the liver is a rare disease that is characterized by multiple regenerative nodules in the hepatic parenchyma without fibrosis. The exact pathogenesis of NRH has not been established, but it's been suggested that obliteration of portal veins may initiate the nodular transformation. It is also known that this disease is associated with autoimmune disease, myeloproliferative disease, lymphoproliferative disease, primary biliary cirrhosis, and some chemotherapy agents. The patients with NRH are usually asymptomatic, yet if they have symptoms, the most common clinical manifestations are those of portal hypertension, including splenomegaly and esophageal varices with or without bleeding. We report a case of nodular regenerative hyperplasia that presented with clinical manifestations similar to those of primary biliary cirrhosis.
Aged ; Diagnosis, Differential ; English Abstract ; Female ; Focal Nodular Hyperplasia/*diagnosis/pathology ; Humans ; Hyperplasia ; Liver/*pathology ; Liver Cirrhosis, Biliary/*diagnosis

No abstract available.
Aged ; Diagnosis, Differential ; Focal Nodular Hyperplasia/*diagnosis/pathology ; Humans ; Liver Diseases/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed

No abstract available.
Diagnosis, Differential ; Focal Nodular Hyperplasia/etiology/*pathology/surgery ; Hepatectomy ; Humans ; Liver Cirrhosis/complications/*diagnosis/pathology ; Male ; Middle Aged