Journal of Liver Cancer

Review Article

Hypervascular hepatic nodules which needs to be differentiated from hepatocellular carcinoma: Mi-Suk Park, Ki Whang Kim; Journal of the Korean Liver Cancer Study Group. 2007;7(1):1-7. Published online June 30, 2007

Abstract PDF: The frequency of hepatic nodular lesion detection has increased due to recent advances in imaging diagnostic techniques. There are many hypervascular hepatic nodules which need to be differentiated from hepatocellular carcinoma. Of these lesions, hepatic adenoma, focal nodular hyperplasia, nodular regenerative hyperplasia, and focal nodular hyperplasia-like nodules will be described in this review article. All of them are hypervascular and so it is needed to differentiate hepatocellular carcinoma.

Case Reports

A Case of Focal Nodular Hyperplasia-like Nodules in Cirrhosis: Young Joon Yoon, Ki Tae Yoon, Jun Yong Park, Hyun Woong Lee, Hwa Sook Kim, Jae Kyung Kim, Young Nyun Park, Kwang-Hyub Han, Chae Yoon Chon, Young Myung Moon, Mi-Suk Park, Sang Hoon Ahn; Journal of the Korean Liver Cancer Study Group. 2007;7(1):41-44. Published online June 30, 2007

Abstract PDF: Focal nodular hyperplasia (FNH) usually occurs in non-cirrhotic livers and was defined as a nodule composed of benign appearing hepatocytes occurring in a liver that is otherwise histologically normal or nearly normal. However, due to improvements in imaging techniques and pathological evaluation of explant livers, a focal lesion that is very similar to the classic form of focal nodular hyperplasia that occurs in cirrhotic liver has been described by several reports. Therefore, the term FNH-like nodules has been proposed. In this report, we report a case of focal nodular hyperplasia-like nodules in cirrhosis. A 59 year old woman with known hepatitis B virus infection visited our institution for routine check up. She was diagnosed as having liver cirrhosis and 3.5 cm sized liver mass on abdomen ultrasonography (US). Because tumor marker was negative and US findings are not compatible with hepatocellular carcinoma, other imaging modalities were performed. Magnetic resonance imaging (MRI) documented a 3.5 cm sized hypervascular nodule with internal aberrant vascular structure and multiple small sized nodules in remaining liver. Needle biopsy was targeted to the liver main mass. Microscopic finding revealed FNH-like nodule and underlying liver cirrhosis.

A Case of Combined Hepatocellular-Cholangiocarcinoma Mimicking Focal Nodular Hyperplasia: Dong Hyun Shin, Kwang Cheol Koh, Geum Youn Gwak, Dong Il Choi, Cheol Keun Park, Moon Seok Choi, Joon Hyoek Lee, Seung Woon Paik, Byung Chul Yoo; Journal of the Korean Liver Cancer Study Group. 2007;7(1):55-58. Published online June 30, 2007

Abstract PDF: Combined hepatocellular and cholangiocarcinoma (cHCC-CC) is an uncommon form of primary liver cancer having features of both hepatocellular and billiary epithelial differentiation. We report a case of cHCC-CC in a patient who was serologically positive for hepatitis B virus. A 39-year-old male was diagnosed by ultrasonography with an asymptomatic tumor in the left lobe of the liver. Based on radiologic and serologic findings of elevated serum alpha-fetoprotein level, a preoperative diagnosis of hepatocellular carcinoma was made, but differential diagnosis included focal nodular hyperplasia, because tumor was enhanced in delayed phase in Godolinium MRI scan. A final diagnosis of cHCC-CC was made after operation.

A Case of Focal Nodular Hyperplasia: Beom Jin Kim, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo, Won Jae Lee, Cheol Keun Park; Journal of the Korean Liver Cancer Study Group. 2003;3(1):61-64. Published online July 31, 2003

Abstract PDF: Focal nodular hyperplasia (FNH) of the liver is a rare benign lesion characterized by nodular hyperplasia of hepatic parenchyma around a central stellate area of fibrosis associated with an anomalous artery. The histological feature of FNH is dominated by a progressive fibrotic process. In the present report, we described a 2.2×2.1 cm sized asymptomatic lesion of FNH observed in a 47-year-old woman with hepatitis B healthy carrier. This lesion was disclosed by various imaging procedures. Under the clinical impression of hepatocellular carcinoma a right. lobe subsegmentectomy was performed. The mass was firm and showed yellow-brownish color and septal fibrosis. It was accompanied with marginal ductal proliferation. These results were consistent with the typical observations in FNH. It also showed small stellate scar with radiating thin fibrous band and formation of small parenchymal nodules. We report a case of FNH of the liver difficult to differentiate hepatocellular carcinoma.

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