Focal Nodular Hyperplasia; Causes, Symptoms, Diagnosis, & Treatment

Imaging studies for focal nodular hyperplasia

Regarding imaging studies, the following can be done in cases of focal nodular hyperplasia:

• Abdominal ultrasound: An abdominal ultrasound is usually the first ordered imaging study in any liver-related complaint. It is not specific to benign tumors and can hardly differentiate between a malignant invading cancer and a benign tumor let alone between the different types of benign tumors. However, it is cheap, fast and can help give a general look on the condition of the liver.
• Abdominal CT scan: A CT scan is a high-resolution imaging study that can detect cancer and differentiate between benign and malignant tumors. If we add contrast, we get what is called a triphasic CT. This imaging study helps differentiate between different benign tumors depending on the pattern of their blood vessels. For instance, a focal nodular hyperplasia has a wheel-shaped blood vessels distribution.
• MRI: Magnetic resonance imaging is not the ideal imaging study for benign tumors but can replace CT scanning in some patients who have a contraindication to CT including pregnant women and those with poor kidney function -because the contrast material injected needs a well-functioning kidney-.

Liver biopsy

Usually, imaging studies and lab tests are enough to exclude a malignant tumor and to confirm a benign one. Yet, in some cases the diagnosis isn’t clear enough and a biopsy is needed. Your doctor will take a small sample from your tumor under local anesthesia and send it for examination. The sample will be examined under the microscope and the pathologist will determine whether the sample is from a benign or a malignant tumor and whether this benign tumor is a focal nodular hyperplasia. Afterwards, the results will be sent back to your treating doctor who will plan the next step, treatment.