[Focal nodular hyperplasia of liver: a clinicopathologic study of 238 patients]

Zhonghua Bing Li Xue Za Zhi. 2011 Jan;40(1):17-22.
[Article in Chinese]

Abstract

Objective: To study the clinicopathologic features of focal nodular hyperplasia (FNH) of liver.

Methods: The clinical, radiologic, pathologic findings and follow-up data of 238 cases of FNH were retrospectively analyzed.

Results: The patients included 93 females and 145 males. The age of the patients ranged from 11 to 77 years (median = 39.1 years). Amongst the 233 patients who had clinical information available, 188 were asymptomatic, 216 had no history of hepatitis B and/or C infection and 232 had negative serum alpha-fetoprotein level. Amongst the 185 patients who had undergone radiologic examination, 123 (66.5%) were accurately diagnosed as such. Macroscopically, of the 284 lesions from 238 patients, the average diameter was 3.7 cm. Two hundred and fifteen cases (90.3%) were solitary, 172 cases were located in the right lobe and 115(40.5%) had central stellate fibrotic scars or lobulated cut surface. Histologically, 229 lesions belonged to classic type and 9 lesions were of non-classic type. The latter was further classified as the telangiectatic form (6 lesions) and the mixed hyperplastic and adenomatous form (3 lesions). There was no evidence of significant cytologic atypia. Follow-up data were available in 173 patients (72.7%). None of them died of the disease and 2 patients suffered from relapses after 2 and 4 years, respectively.

Conclusions: FNH is a hyperplastic response of normal liver cells to local blood flow anomalies. It has no obvious sex predilection and more than 66% can be diagnosed accurately with radiologic examination. The lesions in the current study show no cytologic atypia.

MeSH terms

  • Adenoma, Liver Cell / pathology
  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Carcinoma, Hepatocellular / pathology
  • Child
  • Diagnosis, Differential
  • Female
  • Focal Nodular Hyperplasia / diagnosis
  • Focal Nodular Hyperplasia / diagnostic imaging
  • Focal Nodular Hyperplasia / pathology*
  • Focal Nodular Hyperplasia / surgery
  • Follow-Up Studies
  • Humans
  • Liver / pathology*
  • Liver Neoplasms / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography
  • Young Adult

Supplementary concepts

  • Fibrolamellar hepatocellular carcinoma