Abstract
Focal nodular hyperplasia (FNH) of the liver is relatively rare, and can be difficult to differentiate from other benign tumors arising in the liver. We describe a 23-year-old woman and a 25-year-old man with FNH. They were hospitalized for further evaluation of a space-occupying lesion in the liver. Scintigraphy with Tc-99m diethylenetriaminepentaacetic acid galactosyl human serum albumin (Tc-99m GSA) revealed increased radioactivity in the tumor in one patient and radioactivity similar to that in the normal part of liver in the other. F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) showed uptake similar to that of the normal liver in both patients. FNH was diagnosed on the basis of angiographic findings and histological findings in liver biopsy specimens. Our results show that scintigraphy with Tc-99m GSA and FDG-PET may provide information helpful in the diagnosis of FNH.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Edomondson HA, Peters RL. Tumors of the liver: pathologic features.Semin Roentgenol 18: 75–83, 1983.
Rooks JB, Ory HW, Ishak KG, Strauss LT, Greenspan JR, Hill AP, et al. Epidemiology of hepatocellular adenoma. The rule of oral contraceptive use.JAMA 242: 644–648, 1979.
Welch TJ, Sheedy PF, Johnson CM, Stephen DH, Charboneau JW, Brown ML, et al. Focal nodular hyperplasia and hepatic adenoma: comparison of angiography, CT, US, and scintigraphy.Radiology 156: 593–595, 1985.
Goli M, Mathieu D, Anglade M-C, Cherqui D, Vasile N, Rahmouni A, et al. Focal nodular hyperplasia of the liver: value of color Doppler US in association with MR imaging.Radiology 187: 113–117, 1993.
Belghiti J, Pateron D, Panis Y, Vilgrain V, Flejou JF, Benhamou JP, et al. Resection of presumed benign liver tumors.Br J Surg 80: 380–383, 1993.
Rummeny E, Weissleder R, Sironi S, Stark DD, Comptom CC, Hahn PF, et al. Central scars in primary liver tumors: MR features, specificity, and pathologic correlation.Radiology 171: 323–326, 1989.
Mahfouz A-E, Hamm B, Taupitz M, Wolf K-J. Hypervascular liver lesions: differentiation of focal nodular hyperplasia from malignant tumors with dynamic gadolinium-enhanced MR imaging.Radiology 186: 133–138, 1993.
Wanless IR, Mawdsley C, Adams R. On the pathogenesis of focal nodular hyperplasia of the liver.Hepatology 5: 1194–1200, 1985.
Rogers JV, Mack LA, Freeny PC, Johnson ML, Sones PJ. Hepatic focal nodular hyperplasia: angiography, CT, sonography, and scintigraphy.AJR 137: 983–990, 1981.
Takayasu K, Muramatsu Y, Moriyasu N, Yamazaki S, Takayama T, Hirohashi S, et al. Focal nodular hyperplasia of the liver: arterial angio-CT and microangiography.J Comp Assist Tomogr 16: 212–215, 1992.
Kudo M, Tomita S, Minowa K, Tochio H, Shimada K, Mimura J, et al. Color Doppler flow imaging of hepatic focal nodular hyperplasia.J Ultrasound Med 11: 553–557, 1992.
Yamamoto H, Yamanaka T, Yoshida Y, Miyata M. Detection of focal nodular hyperplasia of the liver with color Doppler ultrasonography.Gastroenterol Jpn 28: 424–430, 1993.
Kerlin P, Davis GL, McGill DB, Weiland LH, Adson MA, Sheedy II PF. Hepatic adenoma and focal nodular hyperplasia: clinical, pathologic, and radiologic features.Gastroenterology 84: 994–1002, 1983.
Cherqui D, Rahmouni A, Charlotte F, Boulahdour H, Métreau J-M, Meignan M. Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations.Hepatology 22: 1674–1681, 1995.
Stadalnik RC, Vera DR, Woodle ES, Trudeau WL, Porter BA, Ward RE, et al. Technetium-99m NGA functional hepatic imaging: preliminary clinical experience.J Nucl Med 26: 1233–1242, 1985.
Kurtaran A, Li S-R, Raderer M, Leimer M, Müller C, Pidlich J, et al. Technetium-99m-galactosyl-neoglycoalbumin combined with iodine-123-try-(A 14)-insulin visualizes human hepatocellular carcinomas.J Nucl Med 36: 1875–1881, 1995.
Sawamura T, Nakada H, Hazama H, Shiozaki Y, Sameshima Y, Tashiro Y. Hyperasialoglycoproteinemia in patients with chronic liver diseases and/or liver cell carcinoma.Gastroenterology 87: 1217–1221, 1984.
Saito K, Koizumi K, Abe K, Goto Y, Seki T. Potential for quantitative diagnosis of tumor and tumors lesions in the liver with Tc-99m-GSA SPECT—Correlation with pathological evaluation and MRI findings—.Ann Nucl Med 12: 275–280, 1998.
Hyodo I, Mizuno M, Yamada G, Tsuji T. Distribution of asialoglycoprotein receptor in human hepatocellular carcinoma.Liver 13: 80–85, 1993.
Kutaran A, Müller C, Novacek G, Kaserer K, Mentes M, Raderer M, et al. Distinction between hepatic focal nodular hyperplasia and malignant liver lesions using technetium-99m-galactosyl-neoglycoalbumin.J Nucl Med 38: 1912–1915, 1997.
Strauss LG, Conti PS. The applications of PET in clinical oncology.J Nucl Med 32: 623–648, 1991.
Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, et al. Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment.J Nucl Med 33: 333–339, 1992.
Torizuka T, Tamaki N, Inokuma T, Magata Y, Sasayama S, Yonekura Y, et al.In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET.J Nucl Med 36: 1811–1817, 1995.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Shiomi, S., Kurooka, H., Iwata, Y. et al. Two cases of focal nodular hyperplasia of the liver: Value of scintigraphy with Tc-99m GSA and positron emission tomography with FDG. Ann Nucl Med 13, 427–431 (1999). https://doi.org/10.1007/BF03164939
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03164939