Focal nodular hyperplasia
Referral for an abdominal ultrasound in a 28 yo female patient with abnormal LFT. Normal body habitus. Six years of prior oral contraceptive pill usage from 16 to 22 yoa.
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In this case, with an abnormal LFT and an otherwise normal appearing liver, what is being missed? I asked the patient about long-term OCP usage, dropped the dynamic range and had another look.
A hypoechoic area with a central scar and stellate blood distribution pattern was seen in segment VII. These findings point to focal nodular hyperplasia, which was confirmed with a CT scan.