Triphasic dynamic CT findings of 63 hepatic focal nodular hyperplasia in 46 patients: correlation with size and pathological findings

Lin, Michael Che-Hung; Tsay, Pei-Kwei; Ko, Sheung‐Fat; Lui, Kar‐Wai; Tseng, Jeng‐Hwei; Hung, Chien-Fu; Wan, Yung‐Liang

doi:10.1007/s00261-007-9258-5

Cited by 13 publications

(8 citation statements)

References 18 publications

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“…[18][19][20] This is important because small FNH lesions are difficult to diagnose on imaging in that they usually do not display the cardinal features of FNH, especially the central scar, which may be absent in 65% to 88% of cases. 10,[30][31][32] In our study, a central scar was identified on microscopy in 60% of cases, not associated with FNH size. Only 33% (n = 5) of FNH lesions simultaneously showed a central scar, ductular proliferation and dystrophic vessels.…”

Section: Pathological Features Gradingsupporting

confidence: 39%

Focal nodular hyperplasia after systemic chemotherapy: Pathological features of a series of 15 cases

Brunet

Beaufrère

Cauchy

et al. 2021

Liver Cancer International

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Introduction Chemotherapy, particularly oxaliplatin, has been associated with the development of focal nodular hyperplasia (FNH). Imaging diagnosis of FNH is well standardized, but it can be misdiagnosed as liver metastasis. The aim of this study was to describe the pathological features of FNH occurring after systemic chemotherapy. Materials and methods From our pathological files for 1990‐2021, we retrieved 15 cases of resected newly developed FNH in adults with liver metastasis treated with systemic chemotherapy. Pathological features of FNH nodules and non‐tumoral liver samples were reviewed. Results In 11/15 (73%) cases, FNH developed after an oxaliplatin‐based regimen. The median interval from the beginning of chemotherapy to the FNH diagnosis was 15 months. FNH was unique in 11 (73%) cases, and the median size of nodules was 1.1 cm [range 0.5‐2.5]. Histologically, 9 (60%), 11 (73%) and 11 (73%) cases exhibited fibrous central scar, dystrophic vessels and ductular proliferation, respectively, with all three criteria present in five (33%) cases. Eight (53%) cases showed intralesional steatosis and nine (60%) cases showed a glutamine synthetase immunostaining map‐like pattern. In non‐tumoral liver, eight (53%) cases exhibited sinusoidal obstruction syndrome and four (27%) nodular regenerative hyperplasia. Conclusion The occurrence of FNH after systemic chemotherapy is an emerging condition challenging the imaging diagnosis because typical morphological features are frequently missing. The presence of sinusoidal changes, including regenerative hyperplasia, in non‐tumoral liver supports the potential role of chemotherapy in the pathogenesis of FNH.

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Section: Pathological Features Gradingsupporting

confidence: 39%

Focal nodular hyperplasia after systemic chemotherapy: Pathological features of a series of 15 cases

Brunet

Beaufrère

Cauchy

et al. 2021

Liver Cancer International

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“…A central scar is seen on CT in approximately 50% of the lesions. Large FNHs (>3 cm) are significantly more likely to reveal central scarring, vascular displacement and abnormal vessels around the lesions than smaller lesions [27,38]. A pseudocapsule is seen in 8% of the FNHs [27].…”

Section: Resultsmentioning

confidence: 99%

Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma

Esschert¹,

Gulik²,

Phoa

2010

Dig Surg

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Background/Aims: There are several imaging modalities available for the detection of focal liver lesions. Differentiation between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is important because of the consequences for management. However, differentiation based on imaging alone still shows limitations. Methods: We reviewed the literature for typical features of FNH and HCA on radiologic and nuclear imaging with emphasis on differentiation of both lesions. Results: Seven articles describe the performance of an imaging modality for the differentiation between FNH and HCA. Limitations of these studies are the small sample size and/or the lack of comparison with the ‘gold standard’, i.e. histological diagnosis. No studies are available that compare the accuracy of several imaging modalities in the differentiation of FNH and HCA. Conventional ultrasound (US) is not useful in the differentiation because of the non-specific features. On contrast-enhanced US, the arterial filling direction of FNH is centrifugal and centripetal in case of HCA. The parenchymal enhancement of FNH is sustained in the portal venous and delayed phases, but shows rapid washout in case of HCA. Multiphase CT scan can differentiate FNH from HCA when there is a central scar. FNH may have a slightly higher relative enhancement in the arterial phase. On MRI with hepatocyte-specific contrast agents, HCA does not show contrast uptake in the hepatobiliary phase in contrast to FNH. Conclusion: We conclude that there is limited evidence of the diagnostic performance of currently used imaging modalities for the differentiation of FNH and HCA. We therefore propose a prospective study (DiFA trial) to determine the accuracy of several radiologic and nuclear imaging studies in differentiating FNH and HCA.

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“…Повышение интенсивности сигнала в артериальную фазу КТ-исследования и, соответственно, гиперваскулярный вид характерны и для ОУГ печени [20]. При этом чувствительность и специфичность КТ-диагностики ОУГ достигают, соответственно, 83 и 92% [21].…”

Section: актуальные вопросы онкологииunclassified

Comparative Analysis of Vascularization Degree of Hepatocellular Carcinoma and Focal Nodular Hyperplasia of the Liver According to Computed Tomography and Morphological Studies

et al. 2013

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A comparative analysis of vascularization degree of hepatocellular carcinoma and focal nodular hyperplasia of the liver according to the multislice computed tomography and histological study of tissue is presented. It was established that computed tomography with bolus contrast enhancement allows to study the characteristics of blood supply of the liver and focal formations. Frequently only the use of this method helps to evaluate specific morphological structure of tumors - hepatocellular carcinoma or focal nodular hyperplasia. As an additional differential diagnostic feature is recommended to increase the density determination of tissue formation in the arterial phase computed tomography study. The maximum of vascularization by computed tomography and immunohistochemistry (with antibodies CD34) are installed in a tissue of highly differentiated hepatocellular carcinoma.

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Triphasic dynamic CT findings of 63 hepatic focal nodular hyperplasia in 46 patients: correlation with size and pathological findings

Abstract: FNHs with different tumor sizes may manifest various dynamic CT findings that are more or less related to the different pathological findings.

Cited by 13 publications

References 18 publications

Focal nodular hyperplasia after systemic chemotherapy: Pathological features of a series of 15 cases

Focal nodular hyperplasia after systemic chemotherapy: Pathological features of a series of 15 cases

Imaging Modalities for Focal Nodular Hyperplasia and Hepatocellular Adenoma

Comparative Analysis of Vascularization Degree of Hepatocellular Carcinoma and Focal Nodular Hyperplasia of the Liver According to Computed Tomography and Morphological Studies

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