Focal nodular hyperplasia
Right upper quadrant discomfort and bloating for 3 months.
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There is a large, discrete area of reduced attenuation arising in relation to the liver parenchyma. Attenuation is reduced by approximately 10 Hounsfield units from 60 to 50 Hounsfield units before intravenous contrast. The largest axial dimensions are 154 x 86 mm.
There is increased arterial enhancement compared to normal liver parenchyma. Increased but patchy enhancement persists through the portal venous phase. The lesion is iso-attenuating in the delayed phase. There is impression of a central low attenuation "scar".
A focal liver lesion shows the characteristics as described. The provisional diagnosis is that of FNH, with increased arterial enhancement and a central scar, the most likely diagnosis in a female of this age.