Multiple Hypervascular FNH-like Lesions in a Patient with No History of Alcohol Abuse or Chronic Liver Disease

Abstract

A 64-year-old Japanese woman with a history of bronchiectasis presented with multiple hypervascular nodules in both lobes of the liver without hepatitis B or C virus infection. Imaging studies, including ultrasound, contrast-enhanced computed tomography and magnetic resonance imaging, showed hypervascularity in the early phase. Histologically, no lipid degeneration was observed; however, there was a mild increase in cell density, miniaturization of nuclei, increased chromatin content, partial sinusoidal dilatation and congestion. No unpaired arteries were evident. The diagnosis based on the pathology and diagnostic radiology findings was multiple hypervascular focal nodular hyperplasia (FNH)-like lesions with no history of alcohol abuse or chronic liver disease.

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases

“…1 Therefore, distinguishing these two conditions based on the radiologic findings is sometimes difficult. In clinical situations, however, differential diagnosis to exclude malignancy is important in order to avoid needless therapeutic interventions.…”

“…A well circumscribed lesion consisting of a stellate scar or a fibrous body surrounded by multiple benign nodules appearing as hepatocytes is the characteristic feature of FNH. 1 The third one is HCA, which consists of a sheet of hepatocytes and is formed as a pseudocapsule related to compression of the adjacent hepatic parenchyma. In contrast to FNH, however, HCA does not form bile ducts.…”