focal nodular hyperplasia
hyperplasia
[hi″per-pla´zhah]focal nodular hyperplasia
A relatively common (±1% of general population) benign lesion that develops spontaneously at age 20–30, predominantly in females, and not associated with oral contraceptives. If multiple (1/3 are multiple), it may be associated with vascular defects in other organs and brain (arteriovenous malformations).Focal nodular hyperplasia
Primary FNH
• Congenital arterial malformation.
Secondary FNH
• Acquired vascular abnormalities;
• Cirrhosis;
• Haemangioma;
• Other neoplasms;
• Venous thrombosis.
Typical FNH
• Cirrhosis-like changes;
• Chronic biliary disease with bile duct loss;
• Adjacent space-occupying lesion.
Atypical FNH
• Large cell atypia;
• Mixed hyperplastic and adenomatous;
• No central scar, especially in lesions < 1cm;
• No prominent ductular reaction;
• Telangiectatic.
Clinical findings
Generally asymptomatic; larger lesions may undergo infarction.
Imaging
Nodular lesion with central scar.
Management
Generally conservative management; indications for surgery uncertain.