Focal Nodular Hyperplasia III — Typical with Follow-up Examination

Two control female Rhesus monkeys in long-term toxicity studies had multiple, palpable nodules in the breast regions. These subcutaneous nodules were 2–7 mm in diameter, firm, and freely movable. No progressive clinical change was observed during a follow-up of 17 or 20 months. Microscopically, one excised nodule consisted of proliferated acinar epithelial cells arranged in lobular patterns. The cells were well differentiated and presented no features of neoplasia. A diagnosis of focal nodular hyperplasia was compatible with the microscopie findings and the clinical follow-up of similar nodules.

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Appearance of Focal Nodular Hyperplasia after Chemotherapy in Two Patients during Follow-Up of Colon Carcinoma

Case Reports in Surgery ◽

10.1155/2021/6676109 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

L. A. de Wert ◽

S. A. Huisman ◽

F. Imani ◽

D. J. de Gooyer ◽

J. M. G. H. van Riel ◽

...

Keyword(s):

Colon Carcinoma ◽

Metastatic Disease ◽

Focal Nodular Hyperplasia ◽

Liver Parenchyma ◽

Liver Lesions ◽

First Case ◽

Nodular Hyperplasia ◽

Magnetic Resonance Imaging Mri ◽

Induced Changes

Surgical liver resection is a treatment option in patients with resectable colorectal liver metastases. We present two cases of focal nodular hyperplasia (FNH) development after treatment with oxaliplatin during follow-up of colon carcinoma. The first case was a 40-year-old male patient who developed multiple liver lesions suspect for metastatic disease four years after he had undergone laparoscopic right-sided hemicolectomy and adjuvant chemotherapy (capecitabine and oxaliplatin). He underwent a metastasectomy of segments three and four and microwave ablation (MWA) of the lesion in segment one. Pathological analysis demonstrated FNH. The second patient was a 21-year-old woman who presented with multiple liver lesions during follow-up for colon carcinoma. She underwent a laparoscopic right-sided hemicolectomy and was adjuvantly treated with capecitabine and oxaliplatin three years ago. Magnetic resonance imaging (MRI) was performed, and the lesions showed no signs of metastatic disease but were classified as FNH. Therefore, the decision was made to follow up the patient. In conclusion, the development of benign liver lesions could occur during follow-up of colon carcinoma and might be caused by oxaliplatin-induced changes to the liver parenchyma. Hence, it is important to distinguish these from metastatic liver disease.

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Long-Term Follow-Up of Atypical Progressive Focal Nodular Hyperplasia Increasing in Size and Number Implicates Its Pathogenesis

The American Journal of Gastroenterology ◽

10.1111/j.1572-0241.2008.01894.x ◽

2008 ◽

pp. ???-???

Keyword(s):

Focal Nodular Hyperplasia ◽

Nodular Hyperplasia ◽

Long Term Follow Up

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Should Focal Nodular Hyperplasia Still be Operated Upon? Analysis of a Case Series

Digestive Diseases ◽

10.1159/000496430 ◽

2019 ◽

Vol 37 (4) ◽

pp. 309-314

Author(s):

Enio Campos Amico ◽

Izadora K. de Souza ◽

Juliana R. Grigório Trigueiro ◽

Fernanda Cunha Miranda ◽

Rogério Lacerda Sousa ◽

...

Keyword(s):

Conservative Treatment ◽

Focal Nodular Hyperplasia ◽

Case Series ◽

Immunohistochemical Analysis ◽

Liver Lesion ◽

Initial Symptom ◽

Asymptomatic Patients ◽

Nodular Hyperplasia ◽

Lesion Growth

Background: Focal nodular hyperplasia (FNH) is a frequent benign liver lesion. Its course is considered benign, and there is no recommendation for its treatment. Nevertheless, the literature presents a high incidence of surgery. Aim: To evaluate the results of conservative treatment in a series of patients with presumed FNH. Methods: The study included patients diagnosed with FNH from May 2007 to July 2017 based on conventional imaging or magnetic resonance imaging with liver-specific contrast (MRI-LSC) or lesion biopsy (histology/immunohistochemical analysis). Patients were followed clinically and using imaging exams. Results: In a total of 54 patients, the diagnosis was obtained by typical findings on computed tomography scan and gadolinium MRI in 48.1% of the patients, by MRI-LSC in 31.5%, and by histological examination in 20.4% of cases. The mean follow-up time was 35.5 months. The initially asymptomatic patients remained symptom-free, and none of those with HNF-related pain had to worsen of the initial symptom. Conservative treatment was effective in 94.4% of the cases. In only 3 cases, there was a need for some therapeutic approach (5.5%); 2 cases for pain and 1 case for lesion growth during follow-up. Conclusion: The present study suggests that it is safe to conservatively manage patients with FNH presumed by highly accurate imaging tests. Similar to hepatic hemangiomas, surgery for FNH should be an exception.

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Focal Nodular Hyperplasia and Hepatocellular Adenoma around the World Viewed through the Scope of the Immunopathological Classification

International Journal of Hepatology ◽

10.1155/2013/268625 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 32

Author(s):

Charles Balabaud ◽

Wesal R. Al-Rabih ◽

Pei-Jer Chen ◽

Kimberley Evason ◽

Linda Ferrell ◽

...

Keyword(s):

Malignant Transformation ◽

Focal Nodular Hyperplasia ◽

Hepatocellular Adenoma ◽

Beta Catenin ◽

Risk Of Bleeding ◽

Great Progress ◽

Nodular Hyperplasia ◽

Immunohistochemical Techniques ◽

Made In

Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are benign hepatocellular tumors. The risk of bleeding and malignant transformation of HCA are strong arguments to differentiate HCA from FNH. Despite great progress that has been made in the differential radiological diagnosis of the 2 types of nodules, liver biopsy is sometimes necessary to separate the 2 entities. Identification of HCA subtypes using immunohistochemical techniques, namely,HNF1A-inactivated HCA (35–40%), inflammatory HCA (IHCA), and beta-catenin-mutated inflammatory HCA (b-IHCA) (50–55%), beta-catenin-activated HCA (5–10%), and unclassified HCA (10%) has greatly improved the diagnostic accuracy of benign hepatocellular nodules. If HCA malignant transformation occurs in all HCA subgroups, the risk is by far the highest in theβ-catenin-mutated subgroups (b-HCA, b-IHCA). In the coming decade the management of HCA will be more dependent on the identification of HCA subtypes, particularly for smaller nodules (<5 cm) in terms of imaging, follow-up, and resection.

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Ultrasound-Guided Percutaneous Thermal Ablation of Hepatic Focal Nodular Hyperplasia——A Multicenter Retrospective Study

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2021.826926 ◽

2022 ◽

Vol 9 ◽

Author(s):

Xuan Yu ◽

Jiandong Chang ◽

Dezhi Zhang ◽

Qiang Lu ◽

Songsong Wu ◽

...

Keyword(s):

Success Rate ◽

Focal Nodular Hyperplasia ◽

Thermal Ablation ◽

Efficacy Rate ◽

Technical Success ◽

Technical Success Rate ◽

Nodular Hyperplasia ◽

Percutaneous Thermal Ablation ◽

The Mean

Background and Aim: To evaluate the clinical effect of ultrasound (US)-guided percutaneous thermal ablation of hepatic focal nodular hyperplasia (FNH).Methods: A retrospective analysis of the clinical data of patients undergoing US-guided percutaneous thermal ablation of FNH from November 2008 to August 2021 at five medical centers in China was conducted.Results: A total of 53 patients were included (26 males and 27 females). The mean age was 35.1 ± 10.8 years. Sixty-five lesions (46 solitary cases and 7 cases with multiple lesions) were included, 70.8% (46/65) of which were located in the right liver lobe. The mean tumor length was 2.9 ± 1.5 cm. All patients successfully completed the ablation treatment. Immediate postoperative imaging showed that the primary technical success rate was 94.3% (50/53). Two patients underwent ablation 3 and 6 months after the primary ablation, and the secondary technical success rate was 100% (2/2). The incidence of complications was 3.8% (2/53). Imaging follow-up was conducted regularly after ablation, and no residual lesion enlargement or tumor recurrence was observed during the follow-up period. The technique efficacy rate was 98.1% (52/53).Conclusion: US-guided percutaneous thermal ablation is a safe and effective treatment for FNH of the liver.

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Long-term follow-up of focal nodular hyperplasia of the liver

The Netherlands Journal of Medicine ◽

10.1016/0300-2977(95)96975-n ◽

1995 ◽

Vol 47 (2) ◽

pp. A11

Author(s):

J DEWILT ◽

R DEMAN ◽

J MALERIS ◽

J IJZERMANS

Keyword(s):

Focal Nodular Hyperplasia ◽

Nodular Hyperplasia ◽

Long Term Follow Up

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An elderly man with progressive focal nodular hyperplasia

Clinical Journal of Gastroenterology ◽

10.1007/s12328-019-01072-9 ◽

2019 ◽

Vol 13 (3) ◽

pp. 413-420

Author(s):

Koichi Hamada ◽

Satoshi Saitoh ◽

Noriyuki Nishino ◽

Daizo Fukushima ◽

Kae Techigawara ◽

...

Keyword(s):

Young Women ◽

Focal Nodular Hyperplasia ◽

Resonance Imaging ◽

Elderly Men ◽

Contrast Enhanced ◽

Nodular Hyperplasia ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography ◽

Hepatocellular Nodules

AbstractPatients with focal nodular hyperplasia (FNH) develop benign hepatocellular nodules. FNH most frequently occurs in young women. There are no reports of the onset of FNH in elderly men. We report a case of FNH in an elderly man, whose nodules increased in number and size. The patient underwent surgery for carcinoma of the left renal pelvis at 69 years of age; no liver masses were noted on yearly follow-up contrast-enhanced computed tomography (CECT). Ten years later, CECT revealed a hepatic mass, and magnetic resonance imaging suggested FNH. The nodules increased in number and size in subsequent follow-up examinations.

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