Focal nodular hyperplasia

Case contributed by Dr Varun Babu


Incidentally detected mass two years ago with no interval growth. Previous histopathology revealed no neoplastic tissue.

Patient Data

Age: 30 years
Gender: Male

Well-defined exophytic lesion with a central hypodense scar in segment VII of the liver protruding inferiorly displacing the kidney, and abutting the adrenal gland. The lesion shows good contrast uptake in the arterial and portal venous phases, homogenizing in the delayed phase. The central scar shows mild progressive filling. A few gallstones are seen. 


Central scar is T2 hyperintense which completely fills up with contrast in 15 min post gadolinum delayed T1 weighted imaging. 

Case Discussion

Young patients with incidental detection of hepatic lesions should generally be considered benign until proven otherwise. Hemangiomas are the most common benign lesions of the liver followed by focal nodular hyperplasias. They are typical with their arterial enhancement homogenizing in portal and equilibrium phases. The central scar shows delayed slow contrast uptake distinguishing it from the uncommon fibrolamellar hepatocellular carcinoma. The MRI obviates the need for histopathology when the T2 hyperintense nature of the scar is confirmed. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.