Focal nodular hyperplasia

Case contributed by Dr Mohamed Abdel-Tawab Mohamed

Presentation

Right hypochondrial pain with liver mass discovered on ultrasound examination.

Patient Data

Age: 25 years
Gender: Female

Triphasic CT Abdomen

CT

A large exophytic right liver lobe hypervascular lesion is seen showing intense enhancement in the late arterial phase with porto-venous washout and fading becoming hard to detect. Multiple branching central hypodense lines showing no arterial enhancement with delayed enhancement making them isodense to surrounding. These lines are representing the central scar. Prominent feeding vessels are seen.

Case Discussion

Focal nodular hyperplasia is the second most common benign hepatic lesion after hemangioma. It shows hypervascular pattern in the triphasic study with the characteristic central scar. The main differential diagnosis is fibrolamellar hepatocellular carcinoma.

Case courtesy of Dr. Abdelrahman Omar.

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