Hepatic adenoma and concurrent focal nodular hyperplasia

Case contributed by Dr Natalie Yang


right upper quadrant pain, ultrasound (performed outside) showed a "liver lesion". For further characterisation.

Patient Data

Age: 30-35 years
Gender: Female

Selected images from liver MRI show a large, subtle T2 hyperintense, well defined rounded lesion in the liver which demonstrates homogenous signal loss on T1 opposed phase scans. Post contrast images, there is prompt arterial enhancement and lesional washout. Incidental lesion lateral to the main one is seen, best appreciated on the arterial phase. 

Case Discussion

Pathology proven hepatic adenoma with an incidental adjacent FNH.

Hepatic Adenomas are benign epithelial neoplasm:

  • Most commonly solitary (multiplicity may suggest liver adenomatosis)
  • Richly vascular tumor which frequently contains hemorrhage and necrosis
  • Pseudocapsule derived from compressed/collapsed hepatic parenchyma
  • Histological hallmark are clusters of benign hepatocytes arranged in sheets or cords with absent bile ducts
  • Adenomas have variable lipid content ranging from
    • Microscopic fat (detected in up to 77% with chemical shift MR) to
    • Macroscopic fat (detected at CT in up 7%)

90% of hepatic adenomas occur in womenAssociations with:

  • Oral contraceptive use
  • Anabolic steroids
  • Glycogen storage disease (Type 1a)
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Case information

rID: 6953
Published: 30th Aug 2009
Last edited: 16th Jul 2018
Tag: liver
Inclusion in quiz mode: Included

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