Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients

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1 Clinical Analysis of Focal Nodular Hyperplasia of the Liver in 11 Patients Purpose: The purpose of this study was to determine the clinical features of focal nodular hyperplasia (FNH) and investigate its diagnosis and treatment. Methods: Eleven patients with FNH treated from January 1997 to January 2007 were analyzed. The clinical findings of pathologically proven FNH were retrospectively reviewed. Results: Among the eleven patients with 18 masses, the mean age was 29.5 (11~57) and the gender ratio (male:female) was 4:7. Four patients had clinical symptoms. Six patients had a solitary mass and five had multiple masses. The mean tumor diameter was 2.73 ± 1.82 cm. The overall rate of a correct preoperative diagnosis was 0% (0/4) by ultrasound, 36.3% (4/11) by CT and 20.0% (2/10) by MRI. Only two patients had a central stellate scar in the mass. All patients underwent hepatic resection without complication. Conclusion: The results of this study showed that the combination of Dynamic CT and dual contrast MRI are important diagnostic methods for FNH. However, a definite preoperative diagnosis of FNH, without a central stellate scar, is very difficult. Surgical resection is recommended for patients with an uncertain diagnosis or clinical symptoms.

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6 Tumors of the liver and intrahepatic bile ducts. In: Armed Forces Institute of Pathology, editor. Atlas of tumor pathology, second fascicle. Washington: Armed Forces Institute of Patholoy; Simutaneous occurrence of adenoma, focal nodular hyperplasia, and hemangioma of the liver: are they derived from a common origin J Gastroenterol Hepatol 2003;18: Diagnosis and treatment of hepatic focal nodular hyperplasia: report of 114 cases. Zhonghua Wai Ke Za Zhi 2006;44: Rupture and hemorrhage of hepatic focal nodular hyperplasia. Am Surg 1995;61: Clinical features of surgically resected focal nodular hyperplasia of the liver. Korean J Hepatol 2004;10: Transarterial emboli-zation as a therapeutic option for focal nodular hyperplasia in four patients. Eur Radiol 2006;16: Laparoscopic resection of focal nodular hyperplasia. Surg Laparosc Endosc Percutan Tech 2003;13: Hepatic focal nodular hyperplasia: angiography, CT, sonography, and scintigraphy. AJR Am J Roentgenol 1981;137: Focal nodular hyperplasia. EJR 2006;58: Focal nodular hyperplasia of the liver in men: is presentation the same in men and women Gut 2002;50: Focal nodular hyperplasia with concomitant hepatocellular carcinoma: a case report and clonal analysis. J Clin Pathol 2004;57: On the pathogenesis of focal nodular hyperplasia of the liver. Hepatology 1985;5: A quantitative gene expression study suggests a role for angiopoietins in focal nodular hyperplasia. Gastroenterology 2003;124: Focal nodular hyperplasia of the liver: a sequela of tumor therapy. Pediatr Radiol 2005;35: and focal nodular hyperplasia of the liver. Gastroenterology 2000;118: Risk factors for focal nodular hyperplasia of the liver: an Italian casecontrol study. Am J Gastroenterology 2002;97: Benign tumors of the liver. Med Clin North Am 1975;59: Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological, and pathological correlations. Hepatology 1995;22: Focal nodular hyperplasia of the liver: radiologic findings. Abdom Imaging 1993;18: Focal nodular hyperplasia of the liver: value of color doppler US in association with MR imaging. Radiology 1993;187: Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol 2005;78: Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology 2001;219:61-68 Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis. Radiographics 2004;23:3-17. MRI of focal nodular hyperplasia(fnh) with gadobenate dimeglumine(gd-bopta) and SPIO(ferumoxides): an intra-individual comparison. J Magn Reson Imaging 2003;17: The typical appearance of focal nodular hyperplasia in triple-phase CT scan, hepatobiliary scan, and Tc-99m sulfur colloid scan with SPECT. Clin Nucl Med 2005;30: Needle-tract implantation from hepatocellular cancer: is needle biopsy of the liver always necessary Liver Transpl 2000;6: Histologic scoring of liver biopsy in focal nodular hyperplasia with atypical presentation. Hepatology 2002; 35: Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol 1999;23:

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