Contribution of CT to characterization of focal nodular hyperplasia of the liver

Abstract

Our personal series of 20 cases of focal nodular hyperplasia (FNH) of the liver is presented. All lesions were studied with computed tomography (CT), 16 of which with surgical control. Retrospective evaluation of the CT features of the identified FNH, along with those of five hepatocellular adenomas (HCA) and 30 hepatocellular carcinomas (HCC), allowed the definition of specific patterns leading to a correct characterization of FNH in 78% of cases. This greatly reduced the diagnostic errors, with the sole exception of patients with fatty liver in whom nuclear medicine may eventually provide a correct characterization. Fine-needle biopsy is thus only necessary in the dubious cases. A precise diagnostic workup of FNH is necessary, since it may avoid the surgical intervention. © 1992 Springer-Verlag New York Inc

Focal Nodular Hyperplasia—A Review of Myths and Truths

“…39,40 Despite the advent of more sophisticated scanning protocols and hardware, there have been no recent studies measuring the sensitivity and specificity of CT for the diagnosis of focal nodular hyperplasia. The typical findings on CT scan are that of a well-circumscribed lesion appearing iso-or hypodense on the non-contrast studies, 41 with a hypodense scar visible in a minority of cases (Fig.…”

Focal nodular hyperplasia that mimicked a liver metastasis from a soft tissue sarcoma: a case report

“…Nevertheless, some FNHs show atypical imaging and are therefore difficult to diagnose accurately. The reported diagnostic ability in determining benign or malignant disease for CT scans is 78% specific [18] that of MRI is 96.6% sensitive and 87.6% specific [19]. To solve this problem, new modalities such as contrast-enhanced ultrasonography and shear-wave elastography [20] have been developed and assessed for diagnostic ability.…”

Hepatocellular carcinoma in association with hepatic focal nodular hyperplasia

“…Other diagnostics, i.e. AFP levels or radiological findings upon CT or MRI, might not contribute to the correct or final diagnosis either, particularly because lesions other than FNH may exhibit structural inhomogeneities or a central fibrous scar and therefore may be misinterpreted as FNH (1,4,7,19,20,22,25,26).…”

“…It has been hypothesized that FNH may be a local hyperplastic response of hepatocytes to a congenital vascular anomaly. The morphological characteristics using different imaging modalities, including CT and magnetic resonance imaging (MRI), and the differentiation between FNH and hepatocellular adenoma or carcinoma have been evaluated by several investigators (1,4,11,13,17,19,20,22,25).…”