Abdominal Imaging

, Volume 19, Issue 1, pp 34–38 | Cite as

Hepatic focal nodular hyperplasia: CT and sonographic spectrum

  • A. Shirkhoda
  • M. C. Farah
  • E. Bernacki
  • B. Madrazo
  • J. Roberts
Article

Abstract

Fifteen patients with pathologically proven focal nodular hyperplasia (FNH) of the liver had abdominal computed tomography (CT) (15) and ultrasound (11). In seven patients, the lesions were incidentally found during gallbladder or renal examination, whereas the other eight had a primary neoplasm and the liver was studied for possible metastasis. In 11 unenhanced CT scans, the ratio of isodense to hypodense lesions was 8 to 3. In 15 contrasten-hanced CT scans, seven were isodense, six were hypodense, and in two, the lesion enhanced (hyperdense). In seven patients a hypodense lesion on unenhanced CT became isodense with contrast injection. Delayed images in three showed the lesions appearing as hypodense in two and displaying a rim of enhancement in one. In one case, unenhanced CT was normal and only enhanced CT showed an area of homogeneous increased density. Ultrasound was done in 11 patients, the lesion was hypoechoic to the liver in five, echogenic in four, and isoechoic in two. Findings of central scar were seen on CT and ultrasound in three cases. Pathologic diagnosis was available in all cases, seven by needle aspiration and eight by surgical resection. In our experience, FNH has many CT and sonographic features that can mimic hemangioma or metastasis. While the presence of a central scar increases the specificity, in a cancer patient, the findings should be interpreted with caution and needle aspiration should be obtained.

Key words

Liver, diseases Liver, neoplasms Computed tomography Ultrasound MRI 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Edmondson HA, Peters RL. Tumors of the liver: pathologic features.Semin Roentgenol 1983;18:75–83PubMedGoogle Scholar
  2. 2.
    Wanless IR, Maudsley C, Adams R. On the pathogenesis of focual nodular hyperplasia of the liver.Hepatology 1985;5:1194–2000PubMedGoogle Scholar
  3. 3.
    Lee MJ, Saini S, Hamm B, et al. Focal nodular hyperplasia of the liver: MR findings in 35 proved cases.AJR 1991;156:317–320PubMedGoogle Scholar
  4. 4.
    Goodman ZD. Benign tumors of the liver. In: Okuda K, Ishak KG, eds.Neoplasms of the liver. Tokyo: Springer-Verlag, 1987:105–125Google Scholar
  5. 5.
    Rogers JV, Mack LA, Freeny PC, Johnson ML, Sones PJ. Hepatic focal nodular hyperplasia: angiography, CT sonography, and scintigraphy.AJR 1981;137:983–990PubMedGoogle Scholar
  6. 6.
    Brady MS, Coit DG. Focal nodular hyperplasia of the liver,Surg Gynecol Obstet 1990;171:377–381PubMedGoogle Scholar
  7. 7.
    Ruschenburg I, Droese M. Fine needle aspiration cytology of focal nodular hyperplasia of the liver.Acta Cytol 1989;33:857–860PubMedGoogle Scholar
  8. 8.
    Yorshikawa J, Matsui O, Masumi K, et al. Delayed enhancement of fibrotic areas in hepatic masses: CT-pathologic correlation.JCAT 1992;162:206–211Google Scholar
  9. 9.
    Welch TJ, Sheedy PF, Johnson CM, et al. Radiographic characteristics of benign liver tumors: focal nodular hyperplasia and hepatic adenoma.Radiographics 1985;5:673–682Google Scholar
  10. 10.
    Kudo M, Tomita S, Tochio H, et al. Hepatic focal nodular hyperplasia: specific findings at dynamic contrast-enhanced US with carbon dioxide microbubbles.Radiology 1991;179:377–382PubMedGoogle Scholar
  11. 11.
    Mathieu D, Bruneton JN, Drouillard J, et al. Hepatic adenomas and focal nodular hyperplasia: dynamic CT study.Radiology 1986;160:53–58PubMedGoogle Scholar
  12. 12.
    Stephens DH, McKusick MA. Retention of contrast material in focal nodular hyperplasia of the liver on delayed CT: another case.AJR 1990;154:422–423PubMedGoogle Scholar
  13. 13.
    Friedman A, Lichtenstein J, Goodman Z, Fishman E, Siegelman S, Dachman A. Fibrolamellar hepatocellular carcinoma.Radiology 1985;157:583–587PubMedGoogle Scholar
  14. 14.
    Rummeny E, Weissleder R, Sironi S, et al. Central scars in primary liver tumors: MR features, specificity, and pathologic correlation.Radiology 1989;171:323–326PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1994

Authors and Affiliations

  • A. Shirkhoda
    • 1
  • M. C. Farah
    • 1
  • E. Bernacki
    • 2
  • B. Madrazo
    • 1
  • J. Roberts
    • 1
  1. 1.Department of Diagnostic RadiologyWilliam Beaumont HospitalRoyal OakUSA
  2. 2.Department of Anatomic PathologyWilliam Beaumont HospitalRoyal OakUSA

Personalised recommendations