Focal nodular hyperplasia of the liver – in our experience

Introduction: Focal nodular hyperplasia (FNH) is a tumour-like lesion of the liver.
Aim: The purpose of the study was to find out if there were any hints from the medical histories or additional investigations which would suggest FNH later confirmed by liver biopsy.
Material and methods: The clinical data of 28 patients with FNH hospitalized in the Department of Gastroenterology, MU of Lublin in the period 1st January, 2002 – 31st October, 2007 were analyzed retrospectively.
Results: Liver biopsy diagnosed FNH in 28 patients (92.86% women) from a total of 667 hospitalized in the Gastroenterology Department, Medical University of Lublin for focal lesions in the liver. In the group of 26 women 16 patients were on oral contraceptives, 5 were taking hypotensives; the men did not receive any medication. All 28 showed normal values of ALT, AST and AFP while each having a single focal lesion 24–121 mm in diameter found in USG. Their medical histories revealed that the FNH was asymptomatic and incidentally detected in USG. A central scar was detected in 9 of 28 patients on USG and in 14 of 23 patients on CT.
Conclusions: In our study FNH was a relatively rare pathology and constituted 4.20% of all cases with focal liver lesions. FNH prevailed in women (particularly who were oral contraceptive users), and did not differentiate in laboratory results. It manifested as a single focus being incidentally detected by imaging techniques with a central scar visualized in 32-60% of patients depending on the techniques applied. Scar absence accounts for the lack of features specific for FNH and then biopsy is the best option to diagnose the lesion.