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Focal Nodular Hyperplasia
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Focal nodular hyperplasia (FNH)
          • Definitions

            • Benign tumor of liver caused by hyperplastic response to localized vascular abnormality

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Cha DI et al: Clinical and imaging features of focal nodular hyperplasia in children. AJR Am J Roentgenol. 202(5):960-5, 2014
                                            2. Cogley JR et al: MR imaging of benign focal liver lesions. Radiol Clin North Am. 52(4):657-82, 2014
                                            3. Purysko AS et al: Characteristics and distinguishing features of hepatocellular adenoma and focal nodular hyperplasia on gadoxetate disodium-enhanced MRI. AJR Am J Roentgenol. 198(1):115-23, 2012
                                            4. Berzigotti A et al: Liver hemangioma and vascular liver diseases in patients with systemic lupus erythematosus. World J Gastroenterol. 17(40):4503-8, 2011
                                            5. Fowler KJ et al: Magnetic resonance imaging of focal liver lesions: approach to imaging diagnosis. Hepatology. 54(6):2227-37, 2011
                                            6. Huang D et al: Transarterial embolization using pingyangmycin lipiodol emulsion and polyvinyl alcohol for the treatment of focal nodular hyperplasia of the liver. Hepatogastroenterology. 58(110-111):1736-41, 2011
                                            7. Kochin IN et al: Benign liver masses and lesions in children: 53 cases over 12 years. Isr Med Assoc J. 13(9):542-7, 2011
                                            8. Mounajjed T et al: Telangiectatic variant of hepatic adenoma: clinicopathologic features and correlation between liver needle biopsy and resection. Am J Surg Pathol. 35(9):1356-63, 2011
                                            9. Shafizadeh N et al: Diagnosis of well-differentiated hepatocellular lesions: role of immunohistochemistry and other ancillary techniques. Adv Anat Pathol. 18(6):438-45, 2011
                                            10. Sutherland T et al: Evaluation of focal hepatic lesions with ultrasound contrast agents. J Clin Ultrasound. 39(7):399-407, 2011
                                            11. Wee A: Fine needle aspiration biopsy of hepatocellular carcinoma and hepatocellular nodular lesions: role, controversies and approach to diagnosis. Cytopathology. 22(5):287-305, 2011
                                            12. Kamel IR et al: Focal nodular hyperplasia: lesion evaluation using 16-MDCT and 3D CT angiography. AJR Am J Roentgenol. 186(6):1587-96, 2006
                                            13. Grazioli L et al: Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology. 236(1):166-77, 2005
                                            14. Vilgrain V et al: Prevalence of hepatic hemangioma in patients with focal nodular hyperplasia: MR imaging analysis. Radiology. 229(1):75-9, 2003
                                            15. Brancatelli G et al: Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology. 219(1):61-8, 2001
                                            16. Grazioli L et al: Focal nodular hyperplasia: morphologic and functional information from MR imaging with gadobenate dimeglumine. Radiology. 221(3):731-9, 2001
                                            17. Casillas VJ et al: Imaging of nontraumatic hemorrhagic hepatic lesions. Radiographics. 20(2):367-78, 2000
                                            18. Leconte I et al: Focal nodular hyperplasia: natural course observed with CT and MRI. J Comput Assist Tomogr. 24(1):61-6, 2000
                                            19. Horton KM et al: CT and MR imaging of benign hepatic and biliary tumors. Radiographics. 19(2):431-51, 1999
                                            20. Buetow PC et al: Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics. 16(2):369-88, 1996
                                            21. Caseiro-Alves F et al: Calcification in focal nodular hyperplasia: a new problem for differentiation from fibrolamellar hepatocellular carcinoma. Radiology. 198(3):889-92, 1996
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Focal nodular hyperplasia (FNH)
                                                    • Definitions

                                                      • Benign tumor of liver caused by hyperplastic response to localized vascular abnormality

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Cha DI et al: Clinical and imaging features of focal nodular hyperplasia in children. AJR Am J Roentgenol. 202(5):960-5, 2014
                                                                                      2. Cogley JR et al: MR imaging of benign focal liver lesions. Radiol Clin North Am. 52(4):657-82, 2014
                                                                                      3. Purysko AS et al: Characteristics and distinguishing features of hepatocellular adenoma and focal nodular hyperplasia on gadoxetate disodium-enhanced MRI. AJR Am J Roentgenol. 198(1):115-23, 2012
                                                                                      4. Berzigotti A et al: Liver hemangioma and vascular liver diseases in patients with systemic lupus erythematosus. World J Gastroenterol. 17(40):4503-8, 2011
                                                                                      5. Fowler KJ et al: Magnetic resonance imaging of focal liver lesions: approach to imaging diagnosis. Hepatology. 54(6):2227-37, 2011
                                                                                      6. Huang D et al: Transarterial embolization using pingyangmycin lipiodol emulsion and polyvinyl alcohol for the treatment of focal nodular hyperplasia of the liver. Hepatogastroenterology. 58(110-111):1736-41, 2011
                                                                                      7. Kochin IN et al: Benign liver masses and lesions in children: 53 cases over 12 years. Isr Med Assoc J. 13(9):542-7, 2011
                                                                                      8. Mounajjed T et al: Telangiectatic variant of hepatic adenoma: clinicopathologic features and correlation between liver needle biopsy and resection. Am J Surg Pathol. 35(9):1356-63, 2011
                                                                                      9. Shafizadeh N et al: Diagnosis of well-differentiated hepatocellular lesions: role of immunohistochemistry and other ancillary techniques. Adv Anat Pathol. 18(6):438-45, 2011
                                                                                      10. Sutherland T et al: Evaluation of focal hepatic lesions with ultrasound contrast agents. J Clin Ultrasound. 39(7):399-407, 2011
                                                                                      11. Wee A: Fine needle aspiration biopsy of hepatocellular carcinoma and hepatocellular nodular lesions: role, controversies and approach to diagnosis. Cytopathology. 22(5):287-305, 2011
                                                                                      12. Kamel IR et al: Focal nodular hyperplasia: lesion evaluation using 16-MDCT and 3D CT angiography. AJR Am J Roentgenol. 186(6):1587-96, 2006
                                                                                      13. Grazioli L et al: Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology. 236(1):166-77, 2005
                                                                                      14. Vilgrain V et al: Prevalence of hepatic hemangioma in patients with focal nodular hyperplasia: MR imaging analysis. Radiology. 229(1):75-9, 2003
                                                                                      15. Brancatelli G et al: Focal nodular hyperplasia: CT findings with emphasis on multiphasic helical CT in 78 patients. Radiology. 219(1):61-8, 2001
                                                                                      16. Grazioli L et al: Focal nodular hyperplasia: morphologic and functional information from MR imaging with gadobenate dimeglumine. Radiology. 221(3):731-9, 2001
                                                                                      17. Casillas VJ et al: Imaging of nontraumatic hemorrhagic hepatic lesions. Radiographics. 20(2):367-78, 2000
                                                                                      18. Leconte I et al: Focal nodular hyperplasia: natural course observed with CT and MRI. J Comput Assist Tomogr. 24(1):61-6, 2000
                                                                                      19. Horton KM et al: CT and MR imaging of benign hepatic and biliary tumors. Radiographics. 19(2):431-51, 1999
                                                                                      20. Buetow PC et al: Focal nodular hyperplasia of the liver: radiologic-pathologic correlation. Radiographics. 16(2):369-88, 1996
                                                                                      21. Caseiro-Alves F et al: Calcification in focal nodular hyperplasia: a new problem for differentiation from fibrolamellar hepatocellular carcinoma. Radiology. 198(3):889-92, 1996