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Large telangiectatic focal nodular hyperplasia presenting with normal radionuclide studies: case report
1Department of Radiology, Montreal General Hospital, Canada.
Summary
Telangiectatic focal nodular hyperplasia can appear typical on CT and ultrasound but may be missed by nuclear medicine scans. This imaging characteristic reflects minimal architectural disruption in this specific focal nodular hyperplasia subtype.
Area of Science:
- Radiology
- Nuclear Medicine
- Pathology
Background:
- Focal nodular hyperplasia (FNH) is a common benign liver lesion.
- The telangiectatic subtype of FNH has distinct histological features.
- Imaging characteristics of telangiectatic FNH can vary.
Purpose of the Study:
- To describe the imaging characteristics of telangiectatic focal nodular hyperplasia.
- To highlight potential discrepancies between conventional imaging and scintigraphy for this lesion type.
Main Methods:
- Case report of a 31-year-old female with an incidentally found 9 cm liver lesion.
- Conventional imaging included X-ray computed tomography and ultrasonography.
- Nuclear medicine scintigraphy utilized technetium-99m (99mTc) colloid, 99mTc-diethyliminodiacetic acid, and 99mTc-labeled red cells.
Main Results:
- X-ray computed tomography and ultrasonography showed a typical appearance of focal nodular hyperplasia.
- Scintigraphy with multiple technetium-99m radiotracers failed to detect any abnormalities.
- Histological examination revealed the telangiectatic form of FNH with minimal architectural disruption.
Conclusions:
- Telangiectatic focal nodular hyperplasia may present with normal scintigraphy findings despite typical conventional imaging.
- The lack of abnormality on scintigraphy is attributed to the lesion's histological characteristics.
- Awareness of these imaging features is crucial for accurate diagnosis of telangiectatic FNH.