Focal nodular hyperplasia (FNH) is the second most common benign solid tumor of the liver and is usually found in young females. In FNH, spontaneous bleeding or rupture rarely occurs and malignant transformation is unlikely. The etiology of FNH is unclear, but because of female predominance and young age at onset, it seems that female hormone has an important role for the development of FNH. Although the development and the complications of hepatocellular adenomas have been related to the use of oral contraceptives and pregnancy, the influence of oral contraceptives and pregnancy on the growth and complications of FNH is controversial. Most FNH are stable in size and rarely complicated during pregnancy. We describe here a case of FNH with growth progression during pregnancy in a 27-year-old female. Her course of pregnancy and delivery was uneventful. Two months after delivery, the size of FNH was decreased.
Adult ; Female ; Focal Nodular Hyperplasia/*diagnosis/radiography/ultrasonography ; Humans ; Liver/pathology/radiography ; Pregnancy ; Tomography, X-Ray Computed ; alpha-Fetoproteins/analysis

No abstract available.
Adult ; Contrast Media/diagnostic use ; Focal Nodular Hyperplasia/pathology/*ultrasonography ; Humans ; Liver/pathology/ultrasonography ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed

OBJECTIVETo explore the diagnosis and treatment of the hepatic focal nodular hyperplasia (FNH).

METHODSThe clinical data of 114 patients with FNH proved by the pathology were analyzed retrospectively.

RESULTSFNH occurs as a single node in 98.1%, ranging from 0.9 cm to 15.0 cm in diameter [average, (4.2 +/- 2.2) cm], only 2 patients had more than one FNH nodules. 86.0% of patients with FNH were below 50 years old. 89.5% of patients were asymptomatic. AFP was negative in all patients. Hepatitis B was negative in 4.4% (5/114) of patients. Of these patients, 50 lesions were in the left lobe, 50 in the right lobe, 6 in the mid lobe, and 8 in the caudate lobe. A big central artery was found in 3.5% (4/113) of the lesion in patients by color Doppler ultrasound. CT scan showed transient immediate enhancement in 94.3% (66/70) of patients, with central scar in 10 cases. The demonstration of a central scar in the lesion was very helpful for the diagnosis of FNH. MRI demonstrated early vigorous enhancement in 91.8% (56/61) of patients. It is strong enhancement on arterial phase and slight or obvious enhancement on portal venous phase and slightly delayed enhancement of the central scars in FNH. Eleven cases showed central scar. MRI was more helpful for the diagnosis of FNH using liver specific contrast agents: superparamagnetic iron oxide (SPIO). All patients underwent focus resection, and there was no mortality and severe complication.

CONCLUSIONFNH shows some typical clinical and imaging features. We could improve the correct diagnosis rate by comprehensively analyzing the clinical and imaging materials.

Adolescent ; Adult ; Child ; Female ; Focal Nodular Hyperplasia ; diagnosis ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography, Doppler, Color

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.
Abdomen/diagnostic imaging ; Aged ; Alcoholism/pathology ; Chronic Disease ; Diagnosis, Differential ; Focal Nodular Hyperplasia/*diagnosis ; Humans ; Imaging, Three-Dimensional ; Liver/diagnostic imaging/*pathology ; Liver Diseases/pathology ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo study the clinicopathologic features of focal nodular hyperplasia (FNH) of liver.

METHODSThe clinical, radiologic, pathologic findings and follow-up data of 238 cases of FNH were retrospectively analyzed.

RESULTSThe patients included 93 females and 145 males. The age of the patients ranged from 11 to 77 years (median = 39.1 years). Amongst the 233 patients who had clinical information available, 188 were asymptomatic, 216 had no history of hepatitis B and/or C infection and 232 had negative serum alpha-fetoprotein level. Amongst the 185 patients who had undergone radiologic examination, 123 (66.5%) were accurately diagnosed as such. Macroscopically, of the 284 lesions from 238 patients, the average diameter was 3.7 cm. Two hundred and fifteen cases (90.3%) were solitary, 172 cases were located in the right lobe and 115(40.5%) had central stellate fibrotic scars or lobulated cut surface. Histologically, 229 lesions belonged to classic type and 9 lesions were of non-classic type. The latter was further classified as the telangiectatic form (6 lesions) and the mixed hyperplastic and adenomatous form (3 lesions). There was no evidence of significant cytologic atypia. Follow-up data were available in 173 patients (72.7%). None of them died of the disease and 2 patients suffered from relapses after 2 and 4 years, respectively.

CONCLUSIONSFNH is a hyperplastic response of normal liver cells to local blood flow anomalies. It has no obvious sex predilection and more than 66% can be diagnosed accurately with radiologic examination. The lesions in the current study show no cytologic atypia.

Adenoma, Liver Cell ; pathology ; Adolescent ; Adult ; Aged ; Biopsy ; Carcinoma, Hepatocellular ; pathology ; Child ; Diagnosis, Differential ; Female ; Focal Nodular Hyperplasia ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Follow-Up Studies ; Humans ; Liver ; pathology ; Liver Neoplasms ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Young Adult