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Results for “Focal Nodular Hyperplasia”

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At least 19 recordsLinked to original sources
PubMed2005

Bland embolization of telangiectatic subtype of hepatic focal nodular hyperplasia.

Focal nodular hyperplasia (FNH) is a common benign liver tumor that is usually treated conservatively. This report describes a histologic subtype of FNH that is more likely to be symptomatic as a result of hemorrhage and necrosis. The patient in this case was treated initially with surgical resection for multiple focal nodular hyperplasias and subsequently with bland embolization of an unresectable, symptomatic lesion.

Adult↗
PubMed2003

Laparoscopic resection of focal nodular hyperplasia.

Focal nodular hyperplasia (FNH) is a benign liver lesion incidentally discovered with increasing frequency because of the proliferation of imaging studies. Radiographic characterization can diagnose this pathologic lesion and nonoperative therapy is the standard of care. However, if radiographic studies and fine needle biopsy are inconclusive, operative intervention may be required. Depending on the anatomic location of the lesion, biopsy and/or resection can be performed laparoscopically. A patient with biliary dyskinesia and focal nodular hyperplasia is presented. She underwent laparoscopic cholecystectomy with excision of the FNH. This paper reviews the case as well as the diagnosis and treatment of FNH.

Adult↗
PubMed2003

Association between Klinefelter syndrome and focal nodular hyperplasia.

Focal nodular hyperplasia is a benign lesion of the liver, predominantly affecting women. Its etiology is unknown. Elevated levels of estrogens have been invoked to play a role in the disease. Klinefelter syndrome is the most common sex chromosome disorder, characterized by 47, XXY karyotype, resulting in male hypogonadism and sex hormone imbalance. We present a case of a 25-year-old man affected by Klinefelter syndrome, admitted to our hospital for aspecific dyspeptic symptoms. During admission he underwent: blood test for the liver function and sexual hormonal status, ultrasonography, echo color power Doppler and computerized tomography scan of the liver, and liver biopsy. A hypergonadotropic hypogonadism was present. Imaging of the liver showed an hepatic lesion that liver biopsy confirmed to be a focal nodular hyperplasia. Although the association could be casual, the sex hormone imbalance present in Klinefelter syndrome may suggest a role in the development of this benign liver lesion.

Adult↗
PubMed1977

Angiographic and pathologic correlations of hepatic focal nodular hyperplasia.

Focal nodular hyperplasia of the liver has a distinctive gross appearance which includes a central fibrous zone containing vessels with a variety of abnormalities. When focal nodular hyperplasia is visualized arteriographically, an artery enters the lesion, branches, and supplies the mass centrifugally. It is likely that the central fibrous zone is the area from which the these branches originate. Nodular hyperplasia is not a life-threatening lesion, except in women taking oral contraceptives who may have massive hemorrhage. If an asymptomatic lesion of the liver has the distinctive arteriographic centrifugal filling pattern of nodular hyperplasia, resection is not recommended as long as oral contraceptives are not used.

Adolescent↗
PubMed2006

Focal nodular hyperplasia.

Focal nodular hyperplasia is the second most common benign liver tumor after hemangioma and occurs predominantly in young women. Imaging techniques are crucial in the diagnosis of this lesion. In this article, we will present the imaging findings of the classic and non-classic FNHs. The role of percutaneous biopsy will also be detailed.

Biopsy↗
PubMed2004

Drug induced hepatic focal nodular hyperplasia.

Focal nodular hyperplasia, an uncommon benign hepatic tumor, has been reported following ingestion of various drugs and chemical agents. The authors report a case of a young girl who developed such lesion following ingestion of anti-tuberculosis drugs for the treatment of her abdominal tuberculosis.

Antitubercular Agents↗
PubMed2006

Intraperitoneal hemorrhage in a patient with hepatic focal nodular hyperplasia.

Focal nodular hyperplasia (FNH) is a common benign liver tumor that is often confused with hepatic adenoma. Despite the benign course of both lesions, hepatic adenomas are associated with rupture and bleeding, and suggested management often includes prophylactic surgical resection. FNH lesions are thought to not rupture or bleed, and traditional management does not include resection. We report the case of a woman with FNH who presented with intraperitoneal hemorrhage after the rupture of a FNH lesion. Only six previous documented cases of hemoperitoneum associated with FNH have ever been reported. This report reviews all previously recorded cases of FNH lesions that have resulted in intraperitoneal hemorrhage. We suggest that although FNH is a benign lesion and intervention is typically unnecessary, the potential for rupture requiring surgical resection should always be considered.

Adult↗
PubMed1998

Multiple focal nodular hyperplasia.

Focal nodular hyperplasia (FNH) is a benign lesion of the liver which usually presents with one or two localizations. We report a patient with history of resection of a biliary cyst, and who had been taking oral contraceptives for the past 18 years, who had multiple localizations of FNH (more than 30 lesions). The largest lesion measured 10.5 x 11 x 12cm. The imaging characteristics of our patient were atypical. A central scar could be demonstrated only in the largest lesion, in an eccentric location. In the other lesions, no scar formations could be detected. Furthermore, imaging characteristics suggested that several of the lesions contained fat. This was confirmed by biopsy. The patient had an associated inflammatory syndrome which could not be otherwise explained. The patient was advised to stop taking the oral contraceptives. Follow-up after 2 years showed that the lesions were unchanged; the inflammatory syndrome persisted. Multiple localizations of FNH are very rare. Sometimes they are associated with malformations in other organs (vascular malformations and neoplasia, mostly of the brain). Often they occur as isolated cases, however. Usually their prognosis seems to be good.

Adult↗
PubMed1991

[The imaging diagnosis of hepatic focal nodular hyperplasia].

Focal nodular hyperplasia (FNH) is a rare benign hepatocellular tumor occurring in noncirrhotic patients, mostly females, 20-50 years of age. It is usually asymptomatic. The authors took the lead from 5 cases of FNH studied over last year to analyze the different patterns exhibited by the condition on the various imaging techniques currently available. At scintigraphy with 99mTc DISIDA or with TcSC, FNH can be hyper, normal, or hypocaptating. On US scans, the lesion is often homogeneous and isoechoic, but it can also be hyper/hypoechoic. With Doppler US, high-flow signals can be observed. On unenhanced CT scans the lesion is solid, well-demarcated, isodense or slightly hyperdense; sometimes it shows a central hypodense area corresponding to fibrovascular scar. On postcontrast scans it appears hyper/isodense. At dynamic CT the lesion density, which is high during the arterial phase, decreases quickly in the parenchymal and the venous phases and reaches equal/inferior values to surrounding liver parenchyma. On liver angio-CT it is sometimes possible to visualize the bile ducts in the central scar. At angiography, FNH is hypervascular and homogeneous. On MR scans, in T1-weighted SE sequences, the condition is isointense or slightly hypointense, whereas on T2-weighted pulse sequences it is slightly hyperintense; the central scar is hypointense on T1, and hyperintense on T2, weighted scans. As we have no pathognomonic patterns but only orientative ones, a reliable differential diagnosis with hepatocellular adenoma (HA) and fibrolamellar hepatocellular carcinoma (FL-HCC) must be based on biopsy or cytology or, even better, histology. The differential diagnosis is nevertheless necessary because, while FNH does not usually require a surgical approach but only a radiological follow-up, both HA (due to possible bleeding and degeneration) and FL-HCC require surgery.

Adult↗
PubMed1986

Nodular regenerative hyperplasia and focal nodular hyperplasia of the liver associated with severe cholestasis. Report of a case with autopsy findings.

Nodular regenerative hyperplasia of the liver was found at liver biopsy and at autopsy in a 61-year-old woman with severe cholestasis. Increased bilirubin levels persisted over a follow-up period of 4 years. Microscopic findings included hyperplastic hepatocytic nodules, interlobular bile duct lesions, fibrous medial and intimal thickening of small arterial branches and portal veins, and recanalization of a thrombus in a major portal branch related to an area of focal nodular hyperplasia of the liver. Bile duct and small vessel changes were prominent in the present case. Their role as contributing factors to the development of nodular regenerative hyperplasia of the liver is discussed.

Atrophy↗
PubMed2006

Preoperative application of selective angiographic embolization in the treatment of focal nodular hyperplasia.

A focal nodular hyperplasia (FNH) rarely requires surgical intervention unless complications or clinical symptoms come into play. In 2 female patients, ages 35 and 44, with symptomatic tumors of that entity (10 and 14 cm, respectively, in size) we performed a laparoscopic liver resection. Directly before undergoing this operation they underwent a selective angiographic embolization of the arterial inflow for control of hemorrhage by application of polyvinyl alcohol particles to the afferent arteries. This procedure led to a complete interruption in arterial inflow and the subsequent laparoscopic resection itself could be carried out as planned with minimal blood loss as well an uncomplicated postoperative course. The patients demonstrated a high degree of subjective satisfaction with the procedure. A reduction in arterial inflow through selective embolization is a useful tool in the preparation for laparoscopic resection of large, well-vascularized liver tumors.

Adult↗
PubMed1996

[Hepatic adenoma and focal nodular hyperplasia: difficult differential diagnosis. Presentation of a case of focal nodular hyperplasia].

Hepatic adenoma and focal nodular hyperplasia are unfrequent benign lesions of the liver with individual histologic characteristics, but not always clinically distinguishable. The main difference is the intratumoral or intraperitoneal bleeding risk (high in adenoma and virtually zero in focal nodular hyperplasia). Surgery is the elective treatment for the first, while a more conservative attitude is allowed for the second. We present the case of a woman with an hepatic mass that clinically and radiologically seemed to be an adenoma. An atypical hepatectomy was done uneventfully. The examination of the specimen showed shaw focal nodular hyperplasia. We review the diagnostic and therapeutic controversy between these entities, because only the histologic examination of the entire surgical specimen could demonstrate the real nature of the lesion.

Adenoma↗
PubMedDate not supplied

[Hepatic peliose, nodular focal hyperplasia of the liver: a propos two cases (author's transl)].

This is a report on the pathology of the liver in two patients under continuous and prolonged oral contraceptives (11 and 8 years): the first had peliose, the other had focal nodular hyperplasia. Present etiopathogenetic theories are reminded: anabolic steroids in peliose and contraceptives in focal nodular hyperplasia. These lesions should be searched systematically in such patients at any laparotomy.

Adult↗
PubMed2001

Focal nodular hyperplasia: imaging findings.

Focal nodular hyperplasia is an uncommon benign hepatic tumor that continues to pose diagnostic dilemmas. Imaging techniques are of great value in diagnosis of this tumor. In this article we present the US, CT, MR imaging, scintigraphy, and angiography findings. The demonstration of a central vascular scar is very helpful. Although the radiologic features may be diagnostic, many atypical cases must be differentiated from other benign or malignant hepatic tumors. In these cases excisional biopsy and histopathologic examination are necessary to determine a definite diagnosis.

Angiography↗
PubMed1991

Hepatic adenoma and focal nodular hyperplasia.

Hepatic adenoma and focal nodular hyperplasia are benign lesions of the liver. The incidence of these conditions has been increasing since 1970. Hepatic adenoma primarily affects young women of childbearing age who have a long history of using oral contraceptives, while focal nodular hyperplasia has a wider age distribution and is not associated with the use of oral contraceptives. The most extensive complication of hepatic adenoma is intratumoral or intraperitoneal hemorrhage, which occurs in 50 to 60 per cent of patients. Patients with focal nodular hyperplasia are usually asymptomatic and rarely experience complications. Hepatic adenoma is distinct from focal nodular hyperplasia both in its clinical behavior and its pathologic features; the two can usually be differentiated radiographically using a combination of radionuclide scanning and angiography. There is a proved association between the use of oral contraceptives and the development of hepatic adenoma; the longer the duration of oral contraceptive use, the more the risk of having hepatic adenoma develop. In addition, users of oral contraceptives who have hepatic adenoma develop are likely to have larger tumors and higher rates of bleeding and rupture than nonusers who have hepatic adenoma develop. Although hepatic adenomas may regress after discontinuation of oral contraceptive use, this is not a consistent finding. In addition, it has now been demonstrated that hepatic adenomas do undergo malignant transformation and that this can be detected by measuring the alpha-fetoprotein level. Focal nodular hyperplasia may be a precursor for fibrolamellar hepatocellular carcinoma. Elective resection of hepatic adenoma has a mortality rate of less than 1 per cent, while the mortality rate with free rupture is 5 to 10 per cent. Because of the relative safety of elective versus emergency resection and the potential for malignant change, the treatment of choice for hepatic adenoma is surgical resection.

Adenocarcinoma↗
PubMed1996

'Undifferentiated progenitor cells' in focal nodular hyperplasia of the liver.

Focal nodular hyperplasia is a tumour like lesion, characterized by a central fibrous scar with irradiating fibrous septa that surround hyperplastic nodules and contain multiple bile ductules. The origin of the bile ductular structures is not clear. Recently, we found evidence for the existence of human counterparts of rat oval cells (potential stem cells) that have the ability of differentiating towards both bile duct cells and hepatocytes. These cells were found in regenerating human liver as well as in chronic cholestatic conditions. Because cholestatic features are seen in focal nodular hyperplasia, we initiated an immunohistochemical study on 23 surgical specimens using antibodies specific for cytokeratins 7 and 19 (bile duct type cytokeratins), OV6 (rat oval cell marker), chromogranin-A (shown to be positive in reactive bile ductules and human oval-like cells) and neural cell adhesion molecule--NCAM (shown to be positive in reactive bile ductules) to investigate whether 'undifferentiated progenitor cells' are also present in focal nodular hyperplasia. Electronmicroscopy was applied in five cases. Bile ductules invariably showed immunoreactivity for CK7 and 19, OV6, chromogranin-A and NCAM. In addition, small individual cells with an oval nucleus and a small rim of cytoplasm, in the vicinity of the septa, were immunoreactive for chromogranin-A, CK7 and 19 and OV6. These cells were hardly recognizable on routine light microscopy. Clusters of periseptal hepatocytes, seemingly in continuity with bile ductular structures, had a transitional phenotype: they stained positive for chromogranin-A, CK7 and OV6 and sometimes formed liver cell rosettes. The number of OV6-positive hepatocytes was greater than the number of chromogranin-A and CK7 positive hepatocytes. This indicates that, in human liver, OV-6 is not purely a marker of progenitor cells. Ultrastructurally, small immature cells, highly resembling rat oval cells, were recognized in the vicinity of septa. In addition, transitional cells displaying characteristics both of hepatocytes and bile duct cells were also present. These results confirm the presence of 'undifferentiated progenitor cells' in focal nodular hyperplasia and suggest that the ductular reaction in these lesions results, at least partly, from activation of these cells.

Animals↗
PubMedDate not supplied

[Focal nodular hyperplasia - own experiences].

INTRODUCTION: focal nodular hyperplasia (FNH) is a benign tumour of the liver, often discovered incidentally. It occurs mainly in women between 25-44 years old. Though it is rarefy reported in children the evidence has been growing in the recent years. THE AIM: of our work was to show our experience of focal nodular hyperplasia in pediatric cases. MATERIAL AND METHODS: 10 children, aged 6-17 years, were hospitalized in the Children's Memorial Health Institute between 2000 and 2005, with provisional diagnosis of focal nodular hyperplasia. In all children radiological examination was performed. In some cases laparotomy and operative liver biopsy was carried out. RESULTS: only in 3 children diagnosis of FNH was made from radiological examination. 6 children needed laparotomy and operative liver biopsy. Although operative resection of FNH lesions was carried out in some patients, the authors observed recurrence of hepatic lesions. CONCLUSIONS: our experiences confirm that nowadays the conservative approach should to be standard procedure in children with FNH. Only in doubtful cases laparotomy is recommended.

Adolescent↗
PubMed1981

A case of focal nodular hyperplasia of the liver.

Focal nodular hyperplasia of the liver is a rare benign tumor of unknown etiology. Presented here is a case of focal nodular hyperplasia of the liver in a 19-year-old man with asymptomatic hepatomegaly. Liver scan and selective hepatic angiography revealed a tumor mass, which was indistinguishable from a malignant tumor. At laparotomy a large mass measured 16 X 10 X 4 cm and weighed 480 gm arising from a part of the left hepatic lobe and extending down to the abdominal cavity was found. The gross and microscopic findings established the diagnosis of focal nodular hyperplasia of the liver. The clinical, radiological and pathological findings in the patient are described in detail.

Adult↗