Angioarchitecture and blood circulation in focal nodular hyperplasia of the liver

Fukukura, Yoshihiko; Nakashima, Osamu; Kusaba, Akiko; Kage, Masayoshi; Kojiro, Masamichi

doi:10.1016/s0168-8278(98)80067-6

Cited by 102 publications

(65 citation statements)

References 19 publications

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“…Increased arterial flow is thought to hyperperfuse the local parenchyma, leading to secondary hepatocellular hyperplasia. FNH is therefore considered the result of a hyperplastic response to increased blood flow (6,(12)(13)(14), and, accordingly, FNH usually does not bleed or undergo malignant transformation, justifying therapeutic abstention.…”

Section: -Clinical and Pathological Characteristics Of Fnhmentioning

confidence: 99%

Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma

Rebouissou¹,

Bioulac‐Sage²,

Zucman‐Rossi³

2008

Journal of Hepatology

223

142

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Section: -Clinical and Pathological Characteristics Of Fnhmentioning

confidence: 99%

Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma

Rebouissou¹,

Bioulac‐Sage²,

Zucman‐Rossi³

2008

Journal of Hepatology

223

142

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“…8,9 Conversely, several studies on the diagnosis of FNH have shown the importance of the drainage vessels. [10][11][12] Fukukura et al 10 studied the drainage vessels of FNH by injecting gelatin into the hepatic artery and portal vein of liver from autopsy and reported 2 pathways of vascular drainage in FNH. In the first pathway, blood entering the nodule from anomalous arteries drains directly into the hepatic veins.…”

Section: Discussionmentioning

confidence: 99%

Visualization of the Drainage Veins With Contrast‐Enhanced Sonography Was Useful in Diagnosis of Small Focal Nodular Hyperplasia

Iijima

Suzuki

Yanagisawa

et al. 2006

J of Ultrasound Medicine

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ocal nodular hyperplasia (FNH) is a benign localized lesion in the liver first reported by Edmondson 1 in 1956. Histologically, FNH is defined as a type of tumorlike lesion. Histopathologically, it is sometimes difficult to differentiate FNH from adenoma. Macroscopically, FNH is a nodule without a capsule showing a central stellate fibrous scar spreading from the center of the nodule radially toward the periphery. 2 These features have been regarded as the determining factors for imaging diagnosis. In dynamic computed tomography (CT) studies, the FNH is isoattenuating before contrast, showing homogenous hyperattenuation in the early arterial phase and isoenhancement during the portal venous phase. Diagnosis is facilitated by the presence of a central scar, but this feature can only be observed in approximately 50% of cases. 3 Although the vascular structure of FNH is said to be characterized by a typical spoke-wheel pattern and a stellate fibrous scar, 4 these features are not readily visualized in small FNH lesions. In such cases, it is necessary to differentiate from other hypervascular malignant tumors such as hepatocellular carcinoma (HCC) and metastatic lesions. 5 The recent advent of multi-detector row CT, 3-dimensional CT, and single-level dynamic CT during hepatic arteriography has allowed detailed visualization of the hemodynamics of FNH. According to these evaluations, the drainage veins of FNH are mainly the hepatic veins, although they sometimes drain directly into the sinusoids surrounding the tumor. 6 However, angiography is invasive, and 3-dimensional volume imaging does not allow real-time presentation. In this case, contrast-enhanced sonography using Levovist (SH U 508A; Schering AG, Berlin, Germany) enhanced the FNH in real time in the early arterial phase and clearly depicted subsequent drainage into the hepatic veins.

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“…FNH is not a true neoplasm, but rather a regenerative hyperplastic response of hepatocytes, secondary to localized vascular abnormalities with a marked female preponderance [Wanless et al, 1985;Fukukura et al, 1998]. This lesion was reported as liver cell adenoma for many years before the disease concept of FNH was defined by Edmondson in 1958 .…”

Section: Focal Nodular Hyperplasia (Fnh)mentioning

confidence: 99%