Focal Nodular Hyperplasia with Retraction of Liver Capsule: A Case Report

Abstract

Focal nodular hyperplasia (FNH) is characterized by the presence a central scar with radiating fibrous septa. Our case had a capsular retraction, which was the result of an extension of the central scar to the surface. In addition, a hypointense scar on the T2-weighted image and a minimal enhancing central scar on the enhanced T1-weighted image, which was due to dense, sclerotic collagenous tissue, were observed. We report the first case of FNH with a capsular retraction.

Atypical Findings of Focal Nodular Hyperplasia with Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced Magnetic Resonance Imaging

“…Atypical findings of FNH have been reported to include hemorrhage, necrosis, fat accumulation, surface retraction, rapid contrast washout, and the absence of a central scar (5, 13, 14). Usually, FNH is not commonly encapsulated, but there is rather often pseudocapsule formation due to compression by the surrounding liver parenchyma.…”

“…It is known to be specific for the diagnosis of FNH, showing hyperintense or isointense regions compared to the liver during the delayed hepatobiliary phase ( 3 , 4 ). Several atypical imaging findings have been reported for FNH ( 5 ), but most are CT-based imaging findings, and there are only a few reports concerning atypical findings in hepatocyte-specific MR contrast-enhanced imaging. Here, we describe two cases of FNH presenting with atypical hepatobiliary phase findings on gadoxetic acid-enhanced MR imaging.…”

Atypical CT and MRI Features of Focal Nodular Hyperplasia of Liver: A Study with Radiologic-Pathologic Correlation

“…Some atypical findings of FNH of patients of he patitis B may include hepatic nodule taking complete enhancement during the early arterial phase of MDCT, the delayed phase without definite washout of the contrast enhancement although the portal venous phase shows iso-attenuation with T2WI showing a high SI and mild diffusion restriction on DWI (b-factor 800) apparent different coefficient imaging with Gadoxetic acid enhanced MRI showing early intense homogenous enhancement and subtle peripheral washout during portal phase and ring like peripheral enhancement with central washout during equilibrium phase and hepatobiliary phase; which gives vague differential diagnosis like well-differentiated HCC, a high grade dysplastic nodule and hepatic adenoma. In this situation, we need to go for USG guided biopsy for confirm diagnosis [6] [17] [18].…”

“…FNH accounts only 2% of hepatic tumors that occurs in childhood (0 -10 years) [3]. Gadoxetic acid, which is taken up by hepatocytes and excreted via bile duct and kidney, is a hepatocyte specific MR contrast agent which is known to be specific for the identifying FNH [4]- [6]. FNH is a benign regenerative nodule comprising disorganized growing normal hepatocytes having an unencapsulated well-defined mass with fibrovascular septae and proliferating bile ductules [7] [8].…”

Hiperplasia nodular focal en mujer joven

“…La HNF es isodensa respecto al hígado en TC, excepto en imágenes en fase arterial tras la inyección de contraste, en las que aparece un realce homogéneo pronunciado que la distingue de hemangiomas y metástasis (7,8). Sin embargo, variaciones en la densidad o hallazgos de imagen atípicos están presentes en cerca del 50 % de los pacientes con HNF; en estos casos, la RM podría ser útil, mostrando en el 78 % de los casos una cicatriz que característicamente se realza intensamente en T2 y mínimamente en T1, a diferencia del HCF, en el que si hay cicatriz ésta suele ser hipointensa (7,9).…”