Presentation
Right upper abdominal pain.
Patient Data
A fairly well-defined 6.0 x 5.0 x 5.2cm lesion at segment VIII of liver appearing hypointense on T2WI with central hyperintense scar. The lesion shows intense arterial enhancement with delayed enhancement of the central scar which typical/characteristic feature of fibronodular hyperplasia. The lesion shows persistent enhancement on portal venous phase. No contrast washout. Background liver is non cirrhotic. No features to suggest fibrolamellar HCC or adenoma. No calcification or haemorrhage. No other similar lesion.
No biliary tree dilatation. Gallbladder, CBD, portal vein, hepatic veins, pancreas, spleen and kidneys appear normal. No ascites or lymphadenopathy.
Case Discussion
Focal nodular hyperplasia is typically seen in you female patients, especially if they are on oral contraceptives. This patient's liver function tests and serum alpha-fetoprotein levels were normal.
Differential diagnosis are hepatic adenoma, fibrolamellar HCC, hypervascular metastasis and haemangioma.
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