Skip to main content
Log in

Focal nodular hyperplasia of the liver: A patient with two concurrent lesions that manifested different behavior on radiographic imaging tests

  • Case Reports of Interest
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Focal nodular hyperplasia (FNH) of the liver is a relatively uncommon pathology, with only 68 cases having been documented to date in Japan. Here, we describe an interesting case; the patient had two concurrent lesions of FNH in segments three (S3) and five (S5), respectively. The two lesions differed from each other in their behavior on various radiographic imagings, i.e., computed tomography, magnetic resonance imaging, and hepatic angiography, leading to a misdiagnosis of hepatocellular carcinoma for the S3 lesion. The patient underwent left lateral hepatic resection, along with excision of the S5 lesion. Histological examination confirmed that these two lesions were FNH. Retrospective assessment of the correlation between the radiographic imagings and the morphological architecture suggested that the architectural differences between the two lesions (i.e., that, in the S3 lesion, the central scar was more developed than in the S5 lesion and was more prominent in the periphery than in the central area of the lesion) had contributed to the misdiagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Makita F, Miyamoto Y, Takeshita M, Owada S, Takeyoshi I, Izumi M, Kakinuma S, Morishita Y (1992) Focal nodular hyperplasia of the liver; a case report of hepatic medial subsegmentectomy (in Japanese with English abstract). Nippon Rinsho Geka Igakukai Zasshi (J Jpn Soc Clin Surg) 53:942–948

    Google Scholar 

  2. Whelan TJ, Baugh JH, Chandor S (1973) Focal nodular hyperplasia of the liver. Ann Surg 177:150–158

    Google Scholar 

  3. Wanless IR, Maudsley C, Adams R (1985) On the pathogenesis of focal nodular hyperplasia of the liver. Hepatology 5:1195–1200

    Google Scholar 

  4. Stauffer JQ, Lapinski MW, Honold DJ, Myers JK (1975) Focal nodular hyperplasia of the liver and intrahepatic hemorrhage in young females on oral contraceptives. Ann Int Med 83:301–306

    Google Scholar 

  5. Edmondson HA (1956) Differential diagnosis of tumors and tumor-like lesions of liver in infancy and childhood. Am J Dis Child 91:168–186

    Google Scholar 

  6. Ishak KG, Rabin L (1975) Benign tumors of the liver. Med Clin North America 59:995–1013

    Google Scholar 

  7. Sandier MA, Petrocelli RD, Marks DS, Lopez R (1980) Ultrasonic features and radionuclide correlation in liver cell adenoma and focal nodular hyperplasia. Radiology 135:393–397

    Google Scholar 

  8. Rummeny E, Weisslender R, Stark DD, Saini S, Compton CC, Bennett W, Hahn PF, Wittenberg J, Malt RA, Ferrucci JT (1989) Primary liver tumors: Diagnosis by MR imaging. AJR 152:63–72

    Google Scholar 

  9. Ebara M, Ohto M, Watanabe Y, Kimura K, Saisho H, Tsuchiya Y, Okuda K, Arimizu N, Kondo F, Ikehira H, Fukuda N, Tateno Y (1986) Diagnosis of small hepatocellular carcinoma: Correlation of MR imaging and tumor histologic studies. Radiology 159:371–377

    Google Scholar 

  10. Vermess M, Leung AW-L, Bydder RE, Steiner RE, Blumgart LH, Young IR (1985) MR imaging of the liver in primary hepatocellular carcinoma. J Comput Assist Tomogr 9:749–754

    Google Scholar 

  11. Dooms GC, Kerlan RK, Hricak H, Wall SD, Margulis AR (1986) Cholangiocarcinoma: Imaging by MR. Radiology 159:89–94

    Google Scholar 

  12. Butch RJ, Stark DD, Malt RA (1986) MR imaging of hepatic focal nodular hyperplasia. J Comput Assist Tomogr 10:874–877

    Google Scholar 

  13. Start DD, Felder RC, Wittenberg J, Saini S, Butch RJ, White ME, Edelman RR, Mueller PR, Simeone JF, Cohen AM, Brady TJ, Ferrucci JT (1985) Magnetic resonance imaging of cavernous hemangioma of the liver: Tissue-specific characterization. AJR 145:213–222

    Google Scholar 

  14. Glaizer GM, Aisen AM, Francis IR, Gyves JM, Lande I, Adler DD (1985) Hepatic cavernous hemangioma of the liver: Magnetic resonance imaging. Radiology 155:417–420

    Google Scholar 

  15. Toma' P, Taccone A, Martinoli C (1990) MRI of hepatic focal nodular hyperplasia: A report of two new cases in the pediatric age group. Pediatr Radiol 20:267–269

    Google Scholar 

  16. Shamsi K, De Schepper A, Degryse H, Deckers F (1993) Focal nodular hyperplasia of the liver: Radiologic findings. Abdom Imaging 18:32–38

    Google Scholar 

  17. Mattison GR, Glazer GM, Quint LE, Francis IR, Bree RL, Ensminger WD (1987) MR imaging of hepatic focal nodular hyperplasia: Characterization and distinction from primary malignant hepatic tumors. AJR 148:711–715

    Google Scholar 

  18. Wilbur AC, Gyi B (1987) Hepatocellular carcinoma: MR appearance mimicking focal nodular hyperplasia, AJR 149:721–722

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

About this article

Cite this article

Takahashi, T., Kakita, A., Nozawa, N. et al. Focal nodular hyperplasia of the liver: A patient with two concurrent lesions that manifested different behavior on radiographic imaging tests. J Hep Bil Pancr Surg 1, 189–194 (1994). https://doi.org/10.1007/BF01222248

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01222248

Key words

Navigation