"The origin of focal nodular hyperplasia is thought to be due to a hyperplastic growth of normal hepatocytes with a malformed biliary drainage system, possibly in response to a pre-existent arteriovenous malformation 1,4. The arterial supply is derived from the hepatic artery whereas the venous drainage is into the hepatic veins. Focal nodular hyperplasia does not have a portal venous supply 9."
"T2* C+ (SPIO) "
"T2* C+ (SPIO) "
Expected headings
"Typical focal nodular hyperplasia"
"Atypical focal nodular hyperplasia"
"Variants"
"Associations"
"Contrast-enhanced ultrasound"
"Microscopically, the lesion is composed of abnormal nodular architecture due to fibrous septa radiation from the central scar. There are thick-walled arteries with fibromuscular hyperplasia and abnormal poorly formed elastic lamina in central scar and fibrous septa. An overt ductular reaction is often seen. Nearly normal hepatocytes are arranged in one to two cell-thick plates , architectural and cytologic atypia is absent 26 . Bile ductules are usually found at the interface between hepatocytes and fibrous regions 1,2. Kupffer cells are present 4,7. Immunohistochemistry for glutamine synthetase (GS) has a highly characteristic "map-like pattern" of strong cytoplasmic GS staining in hepatocytes 26 ."
"There is no malignant potential 1."
"In the portal venous phase, the lesion becomes slightly hyperattenuating or isoattenuating to liver and poorly visualised in many studies, the central scar remains hypodense. Focal nodular hyperplasia is generally not associated with fat, calcification or haemorrhage."
"hepatic adenoma: usually more heterogeneous CT portal and delayed phases contrast washout; no gadoxetate retention on delayed phase MR and associated with fat, calcification or haemorrhage"
"hepatic adenoma: usually more heterogeneous CT portal and delayed phases contrast washout; no gadoxetate retention on delayed phase MR and associated with fat, calcification or haemorrhage"
"hepatocellular carcinoma (HCC): usually in cirrhosis; vascular invasion"
"hypervascular hepatic metastases: usually multiple; CT portal and delayed phases hypodense (washout); older patients with known primary tumour"
"hypervascular hepatic metastases: usually multiple; CT portal and delayed phases hypodense (washout); older patients with known primary tumour"
"hepatic haemangioma: peripheral and centripetal enhancement; blood vessels isodense; no central scar; only small ones with rapid enhancement simulate focal nodular hyperplasia"
"hepatic haemangioma: peripheral and centripetal enhancement; blood vessels isodense; no central scar; only small ones with rapid enhancement simulate focal nodular hyperplasia"
"hepatic haemangioma: peripheral and centripetal enhancement; blood vessels isodense; no central scar; only small ones with rapid enhancement simulate focal nodular hyperplasia"
"focal nodular hyperplasia typically has no capsule; if a hypervascular liver mass has a capsule, put hepatocellular carcinoma above focal nodular hyperplasia on the differential diagnosis"
"there is likely overlap in appearance between focal nodular hyperplasia and inflammatory hepatic adenoma when using gadoxetate sodium (Eovist/Primovist); if the patient has risk factors (e.g. metabolic syndrome), consider both in the differential diagnosis 15"