Nodular regenerative hyperplasia of the liver: clinical and radiologic observations

Dachman, A H; Ros, Pablo R.; Goodman, Zachary; Olmsted, William W.; Ishak, Kamal G.

doi:10.2214/ajr.148.4.717

Cited by 106 publications

(60 citation statements)

References 19 publications

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“…16 NRH often is combined with various systemic diseases or cytotoxic and immunosuppressive drug intake, which can induce thrombotic venopathy. [33][34][35][36][37] NRH now is considered a major cause of portal hypertension in young, noncirrhotic patients. 33,34 NRH lesions often are multiple and hyperechoic on US scans and hypodense with no significant enhancement and no central scar on CT scans.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Bouyn

Leclère

Raimondo

et al. 2003

Cancer

132

126

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BACKGROUNDThe detection of hepatic nodules, particularly in patients treated for a previous malignancy, raises a diagnostic dilemma. Focal nodular hyperplasia (FNH) of the liver is an uncommon, benign tumor in children and must be differentiated from malignant hepatic lesions. The etiology of FNH is obscure, and its pathogenesis is poorly understood. FNH may be a reaction to localized vascular abnormalities and circulatory disturbances. The goal of the current study was to identify risk factors for the occurrence of FNH in children who had received prior treatment for a malignant tumor.METHODSThe current retrospective study examined 14 cases of FNH in pediatric patients who previously had been treated for a malignancy. Diagnosis was based on clinical and radiologic findings and was proven histologically in four cases.RESULTSFNH lesions were discovered by chance during routine examination in 78% of patients. The incidence of FNH was particularly high in the current series (0.45%) compared with the incidence in the general pediatric population. High doses of alkylating agents (e.g., busulfan or melphalan), venoocclusive disease, and liver radiotherapy may be responsible for injury to the vascular endothelium and subsequent localized circulatory disturbances. FNH is characterized by the absence of complications after its detection; therefore, only close follow‐up is recommended.CONCLUSIONSFNH appears to be a late complication of an iatrogenic vascular disease in children with a history of malignancy. Cancer 2003;97:3107–13. © 2003 American Cancer Society.DOI 10.1002/cncr.11452

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Section: Discussionmentioning

confidence: 99%

“…33,34 NRH lesions often are multiple and hyperechoic on US scans and hypodense with no significant enhancement and no central scar on CT scans. [32][33][34][35][36] Histologic examination usually is necessary to establish the diagnosis of NRH. 32,33 The pathogenesis of FNH remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Bouyn

Leclère

Raimondo

et al. 2003

Cancer

132

126

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“…NRH is a distinct pathologic entity characterized by the presence of diffuse regenerative nodules of hepatocytes in the periportal areas without hepatic cirrhosis or fibrosis [1,2]. Liver biopsy with a large tissue sample is necessary to ascertain the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Although this is a well-known and well-defined histological entity, it is less familiar to radiologists [1]. One reason may be that imaging findings are often normal, so that only a few cases have been reported in the radiologic literature.…”

mentioning

confidence: 99%

Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases

et al. 1999

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We described the sonographic, computed tomographic (CT), and magnetic resonance (MR) imaging features of one atypical case of nodular regenerative hyperplasia of the liver. The presence of multiple hepatic nodules suggested the diagnosis of metastatic disease to the liver because of a peripheral rim of enhancement on CT obtained after intravenous administration of contrast material and a halo sign on T2-weighted spin-echo MR imaging. Examination of the pathologic specimen obtained after surgical biopsy showed that the nodules were made of hepatocytes, with a nodular arrangement surrounded by peliosis, without fibrosis or cirrhosis. These findings suggested that peliosis may cause peripheral rim of enhancement on CT and halo sign on MR imaging. In light of this case, nodular regenerative hyperplasia of the liver should be considered in the differential diagnosis of hepatic metastases.

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“…On sonograms NRH usually appears as hypoechoic or isoechoic masses with anechoic centers (suggesting hemorrhage); on CT the nodules are hypodense, with minimal or no enhancement. 8,9 However, as shown in Figure 8, NRH nodules may also show moderate to severe fatty metamorphosis and no central hemorrhage, with homogeneous hyperechoic features on sonograms and no enhancement on CT scans.…”

Section: Nodular Regenerative Hyperplasia Of the Livermentioning

confidence: 99%

Hyperechoic hepatic nodules: Correlation of findings from sonography, CT, and pathologic analysis

Kim

Jung

Jeong

et al. 2004

J of Clinical Ultrasound

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Nodular regenerative hyperplasia of the liver: clinical and radiologic observations

Cited by 106 publications

References 19 publications

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Imaging features of nodular regenerative hyperplasia of the liver mimicking hepatic metastases

Hyperechoic hepatic nodules: Correlation of findings from sonography, CT, and pathologic analysis

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