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Focal nodular hyperplasia with major sinusoidal dilatation: a misleading entity
Hervé Laumonier1, Nora Frulio, Christophe Laurent
1Radiology Department, Hôpital St André CHU Bordeaux, Bordeaux, France. herve.laumonier@chu-bordeaux.fr
BMJ Case Reports
|July 17, 2012
Summary
Focal nodular hyperplasia (FNH), a benign liver lesion, can mimic hepatocellular adenoma (HCA) on imaging. This case highlights how microscopic analysis confirmed FNH with sinusoidal dilatation, despite initial imaging suggesting HCA.
Area of Science:
- Hepatology
- Gastroenterology
- Diagnostic Imaging
Background:
- Focal nodular hyperplasia (FNH) is a common benign liver lesion often linked to increased blood flow.
- Distinguishing FNH from hepatocellular adenoma (HCA) can be challenging, particularly with atypical presentations.
- Advanced imaging has improved diagnostic accuracy for liver lesions.
Observation:
- A 47-year-old woman presented with a solitary liver lesion.
- Initial imaging suggested an inflammatory hepatocellular adenoma with sinusoidal congestion.
- The lesion exhibited atypical features requiring further investigation.
Findings:
- Microscopic examination revealed the lesion to be focal nodular hyperplasia.
- Specific immunostaining and molecular analysis confirmed the diagnosis.
- The FNH presented with significant sinusoidal dilatation, characteristic of telangiectatic FNH.
Implications:
- This case underscores the importance of integrating imaging findings with histopathological analysis for accurate liver lesion diagnosis.
- It highlights the diagnostic challenges posed by atypical FNH presentations.
- Accurate differentiation between FNH and HCA is crucial for appropriate patient management and treatment strategies.
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