Presentation
Work up for abdominal pain. Reported hepatic mass on US evaluation.
Patient Data
The hepatic attenuation value is less than that of the spleen, suggesting fatty liver.
A 75 mm isodense mass with lobulated margin and the central scar is noted at the liver with bright contrast enhancement in the arterial phase. The central scar of the lesion remains low attenuation in early phases and shows mild enhancement on delayed images. Features are most likely compatible with focal nodular hyperplasia (FNH).
In addition, a low attenuation hepatic lesion, measuring 15 mm in diameters, is depicted, located at the left liver lobe, revealing early peripheral, nodular enhancement, and centripetal filling. Hemangioma is a probable diagnosis.
Case Discussion
On CT/ MR images, typical focal nodular hyperplasia demonstrates bright, homogeneous arterial contrast enhancement except for the central scar, which remains hypoattenuating. The fibrotic scar shows enhancement on delayed scans in up to 80% of cases.
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