Focal Nodular Hyperplasia

Solitary or multiple benign hepatic vascular tumors, usually occurring in women of 20-50 years of age. The nodule, poorly encapsulated, consists of a central stellate fibrous scar and normal liver elements such as HEPATOCYTES, small BILE DUCTS, and KUPFFER CELLS among the intervening fibrous septa. The pale colored central scar represents large blood vessels with hyperplastic fibromuscular layer and narrowing lumen.

Also Known As:

Networked: 371 relevant articles (10 outcomes, 29 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Liver Cell Adenoma (Hepatocellular Adenoma)
2.	Cicatrix (Scar)
3.	Hepatitis
4.	Leiomyoma (Uterine Fibroids)
5.	Hemangioma (Angioma)

Experts

1.	Bioulac-Sage, Paulette: 7 articles (08/2014 - 03/2003)
2.	Balabaud, Charles: 7 articles (08/2014 - 03/2003)
3.	Kondo, Fukuo: 4 articles (10/2015 - 01/2004)
4.	Zucman-Rossi, Jessica: 4 articles (03/2009 - 05/2007)
5.	Grazioli, Luigi: 4 articles (07/2008 - 05/2002)
6.	Fukusato, Toshio: 3 articles (10/2015 - 11/2013)
7.	Colombo, Massimo: 3 articles (05/2015 - 02/2002)
8.	Saito, Kazuhiro: 3 articles (10/2014 - 11/2009)
9.	Moriyasu, Fuminori: 3 articles (10/2014 - 11/2009)
10.	Sugimoto, Katsutoshi: 3 articles (10/2014 - 11/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Focal Nodular Hyperplasia:

1.	Contrast MediaIBA 12/01/2013 - "Hepatobiliary-secreted MRI contrast agents have improved the ability to diagnose focal nodular hyperplasia and may also improve the detection and imaging diagnosis of HCC. " 05/01/2003 - "To compare the efficacy of two different MR contrast agents for the detection and diagnosis of focal nodular hyperplasia (FNH). " 05/01/1997 - "To demonstrate the improved specificity of liver MRI in diagnosis of focal nodular hyperplasia (FNH) using liver specific contrast agents. " 12/01/2002 - "The objective of our study was to describe the functional and differential uptake features of atypical focal nodular hyperplasia using different MR contrast agents and to evaluate their potential role in the diagnosis and characterization of focal nodular hyperplasia. " 02/01/2014 - "Part 1: MRI features of focal nodular hyperplasia with an emphasis on hepatobiliary contrast agents."
2.	GadoliniumIBA 09/01/2002 - "This study aimed at presenting the three-dimensional gadolinium-enhanced magnetic resonance angiography findings of hepatic focal nodular hyperplasia with angiographic correlation. " 07/01/1991 - "Twenty-two patients with 25 cases of focal nodular hyperplasia (FNH) proved with pathologic study were imaged with a TurboFLASH (fast low angle shot) sequence combined with bolus administration of gadolinium tetraazacyclododecanetetraacetic acid (DOTA), spin-echo (SE) T2-weighted sequences, and postcontrast T1-weighted sequences. " 07/01/2012 - "We report a case of a patient who presented with the rare profile of multiple, confluent lesions that were diagnosed, using magnetic resonance imaging with gadolinium-dimeglumine, as focal nodular hyperplasia. " 04/01/2005 - "Multiple focal nodular hyperplasia syndrome: diagnosis with dynamic, gadolinium-enhanced MRI." 05/01/2004 - "Six criteria for typical focal nodular hyperplasia were required: iso- or hypointensity on T1-weighted sequences and iso- or slight hyperintensity on T2-weighted sequences; homogeneous signal intensity; central hyperintense area on T2-weighted sequences; marked lesion contrast enhancement; accumulation of gadolinium chelates within the central area on delayed contrast-enhanced T1-weighted sequences; and absence of capsule. "
3.	ferric oxide (iron oxide)IBA 01/01/2012 - "We evaluated the diagnostic efficacy of gadoxetic acid- and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for focal nodular hyperplasia (FNH). " 01/01/2012 - "MR characterization of focal nodular hyperplasia: gadoxetic acid versus superparamagnetic iron oxide imaging." 03/01/2006 - "[Focal nodular hyperplasia of the liver: imaging findings with emphasis on the findings of superparamagnetic iron oxide-enhanced MR imaging]." 03/01/2005 - "Focal nodular hyperplasia of the liver: usefulness of superparamagnetic iron oxide-enhanced magnetic resonance imaging." 12/01/2002 - "On iron oxide-enhanced T2-weighted images, all focal nodular hyperplasia lesions showed uptake of the contrast agent, but contrast uptake in the lesions was less than in the surrounding parenchyma. "
4.	ferumoxides (Feridex)FDA Link 07/01/2000 - "Focal nodular hyperplasia shows significant decrease in signal intensity on ferumoxides-enhanced T2-weighted images, which may aid in the differentiation of focal nodular hyperplasia from other focal hepatic lesions. " 07/01/2000 - "Focal nodular hyperplasia showed significant signal intensity loss on ferumoxides-enhanced T2-weighted images (mean, -43%+/-6.7%, p < 0.01). " 01/01/1999 - "Focal nodular hyperplasia of the liver on ferumoxides-enhanced MR imaging: features on conventional spin-echo, fast spin-echo and gradient-echo pulse sequences." 01/01/1999 - "The aim of this study was to assess the efficacy of a superparamagnetic iron oxide, ferumoxides, in the detection and characterization of focal nodular hyperplasia (FNH) on MR conventional spin-echo (SE), fast spin-echo (FSE) and gradient-echo (GRE) images. " 04/01/2007 - "Focal nodular hyperplasia: intraindividual comparison of dynamic gadobenate dimeglumine- and ferucarbotran-enhanced magnetic resonance imaging."
5.	Glutamate-Ammonia Ligase (Glutamine Synthetase)IBA 01/01/2014 - "The glutamine synthetase staining pattern was map-like in 90% of focal nodular hyperplasia cases, with the remaining 10% of cases showing pseudo map-like staining. " 12/01/2012 - "Immunostaining of glutamine synthetase is a sensitive and specific marker for diagnosing focal nodular hyperplasia in needle biopsy." 03/01/2009 - "Over-expression of glutamine synthetase in focal nodular hyperplasia: a novel easy diagnostic tool in surgical pathology." 01/01/2014 - "Three cases were labeled as indeterminate and showed focal nodular hyperplasia-like morphology but lacked map-like glutamine synthetase staining pattern; these cases demonstrated a patchy pseudo map-like glutamine synthetase pattern along with the expression of serum amyloid-associated protein. " 01/01/2014 - "Expression of serum amyloid-associated protein in inflammatory hepatocellular adenoma and map-like pattern of glutamine synthetase in focal nodular hyperplasia can be helpful in this distinction, but the pitfalls and limitations of these markers have not been established. "
6.	Pentetic Acid (DTPA)FDA LinkGeneric 05/01/2014 - "Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging is helpful in diagnosing hypervascular pseudotumors, focal nodular hyperplasia, and nodular lesions associated with alcohol-induced hepatitis. " 12/01/2011 - "We report a case of focal nodular hyperplasia in a patient for whom gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and histological analysis results were available. " 07/01/2008 - "The aim of this prospective study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) of the liver with the hepatocellular-specific contrast agent gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) in comparison to precontrast MRI and spiral computed tomography (CT) in the specific diagnosis of focal nodular hyperplasia (FNH) and to describe morphologic features and enhancement pattern of FNH. "
7.	Amyloid (Amyloid Fibrils)IBA 01/01/2014 - "Positive staining for serum amyloid-associated protein was seen in the majority of inflammatory hepatocellular adenomas (92.6%) and in the minority of focal nodular hyperplasia (17.5%). " 01/01/2014 - "Three cases were labeled as indeterminate and showed focal nodular hyperplasia-like morphology but lacked map-like glutamine synthetase staining pattern; these cases demonstrated a patchy pseudo map-like glutamine synthetase pattern along with the expression of serum amyloid-associated protein. " 01/01/2014 - "Expression of serum amyloid-associated protein in inflammatory hepatocellular adenoma and map-like pattern of glutamine synthetase in focal nodular hyperplasia can be helpful in this distinction, but the pitfalls and limitations of these markers have not been established. " 01/01/2014 - "Our results highlight the diagnostic errors that can be caused by variant patterns of staining with glutamine synthetase and serum amyloid-associated protein in inflammatory hepatocellular adenoma and focal nodular hyperplasia. " 01/01/2014 - "Diagnostic utility and limitations of glutamine synthetase and serum amyloid-associated protein immunohistochemistry in the distinction of focal nodular hyperplasia and inflammatory hepatocellular adenoma."
8.	Radioactive TracersIBA 09/01/1989 - "The different biokinetic behaviour of radioactive tracers which can be monitored by nuclear medicine procedures may be helpful in the diagnosis or differential diagnosis of tumours or tumour-like lesions of the liver or pancreas: autologous red blood cells in the detection of haemangiomas; iminodiacetates in delineation of focal nodular hyperplasia, resp. "
9.	Oral ContraceptivesIBA 02/01/2002 - "This study confirms previous clinical observations, and provides a quantitative estimate of the association between use of oral contraceptives and focal nodular hyperplasia of the liver." 07/01/2005 - "Focal nodular hyperplasia (FNH) is one such tumour, most frequently an asymptomatic tumour of the liver, which predominantly appears in women during the generative period, who have taken oral contraceptives for several years. " 02/01/2002 - "Oral contraceptives and the risk of focal nodular hyperplasia of the liver: a case-control study." 11/01/2001 - "These results suggest that there is no direct relationship of focal nodular hyperplasia with oral contraceptives. " 11/01/2001 - "Enlarged focal nodular hyperplasia of the liver under the influence of oral contraceptives."
10.	Colloids (Colloid)IBA 09/01/2013 - "Hybrid single photon emission computed tomography/computed tomography sulphur colloid scintigraphy in focal nodular hyperplasia." 02/01/2001 - "A (99m)technetium-labelled sulphur colloid scan, however, revealed areas of increased uptake consistent with multiple focal nodular hyperplasia. " 04/01/2000 - "Nuclear medicine tracers, including colloids and hepatobiliary agents showing the characteristic findings of focal nodular hyperplasia: Hypervascularization, normal uptake of colloids, accumulation of hepatobiliary tracer and hot spots due to the retention of this tracer during the clearance fhase. " 04/01/1991 - "Focal nodular hyperplasia (FNH) has been shown to have variable colloid uptake, which is dependent upon the number of Kupffer cells per given volume. " 01/01/1991 - "Detection of focal nodular hyperplasia with liver colloid single photon emission computed tomography: a case report and review of the literature."

Therapies and Procedures

1.	Hysterectomy 06/04/1979 - "A case of focal nodular hyperplasia of the right hepatic lobe was discovered during the hysterectomy operation of a 40 year old woman. " 01/01/1980 - "[Focal nodular hyperplasia of the liver discovered and biopsied during hysterectomy for fibroids secondarily treated by paramendian bisectoriectomy with cure for more than one year (author's transl)]."
2.	Hepatectomy 09/01/2012 - "Laparoscopic partial hepatectomy of focal nodular hyperplasia." 04/01/2010 - "Focal nodular hyperplasia (FNH) of the liver is rare in children, and it is usually diagnosed through a biopsy of the liver or hepatectomy. " 12/01/2007 - "[Laparoscopic hepatectomy of a focal nodular hyperplasia of the liver]." 11/01/2003 - "A 31-year-old woman underwent microwave-assisted laparoscopic hepatectomy of the left lateral segment for focal nodular hyperplasia on January 14, 1998. " 07/01/1976 - "Because of the risks of partial hepatectomy, hepatic artery ligation is suggested as the treatment of choice for focal nodular hyperplasia."
3.	Contraception (Birth Control) 01/01/1991 - "[Hormonal contraception and focal nodular hyperplasia]." 06/05/1976 - "[Letter: Benign focal nodular hyperplasia of the liver without oral contraception]." 10/01/2009 - "Of 148 articles, three publications of two studies met the criteria for inclusion in this review; both investigated the use of hormonal contraception in women with the benign liver tumor focal nodular hyperplasia (FNH). " 12/01/1987 - "It is concluded that conservative management after withdrawal of hormonal contraception my be the preferable treatment for hepatic adenoma and focal nodular hyperplasia." 08/01/2005 - "Two cases of fibrolamellar hepatocellular carcinoma arising in a background of focal nodular hyperplasia followed long-term oral contraception, and 1 of the 2 occurred during pregnancy. "
4.	Laparotomy 01/01/2013 - "Von Meyenburg complexes mimicking metastatic disease at laparotomy for focal nodular hyperplasia." 01/21/1997 - "Focal nodular hyperplasia, if found incidentally during laparotomy, should be removed en-passant. " 05/01/1994 - "The tumour was removed at laparotomy and was diagnosed as an area of focal nodular hyperplasia on histopathological examination." 01/01/1994 - "27 symptomatic cases over 50 focal nodular hyperplasia (FNH) were resected, 7 cases were resected and 3 biopsied during laparotomy performed for other pathology. " 10/01/1986 - " During a second laparotomy 2 months later for curative resection, another nodular mass 2 cm in diameter was found on the left lobe, apparently a focal nodular hyperplasia. "
5.	Liver Transplantation 01/01/2010 - "Focal nodular hyperplasia after orthotopic liver transplantation." 02/15/2006 - "Liver-occupying focal nodular hyperplasia and adenomatosis associated with intrahepatic portal vein agenesis requiring orthotopic liver transplantation." 09/01/2015 - "Liver Transplantation for Budd-Chiari Syndrome With Large Solitary Focal Nodular Hyperplasia of the Liver in a Patient With Essential Thrombocytemia: Case Report." 11/01/2012 - "Liver transplantation for refractory severe pruritus related to widespread multifocal hepatic focal nodular hyperplasia (FNH) in a child: case report and review of literature." 07/01/2001 - "We describe a case of successful orthotopic liver transplantation in a 57-year-old man with Laënnec's cirrhosis using a liver containing an 8-cm focal nodular hyperplasia (FNH) lesion involving segments II and III and the caudate lobe. "