Multiple Focal Nodular Hyperplasia of the Liver in - Department of ...

592 Kim et al.
Journal of
Gastrointestinal Surgery
Fig. 1. Arterial phase CT imaging of multiple FNH. Arterial phase images through the superior (A)
and inferior (B) liver. A, There is a heterogeneous mass in the left lateral segment that is not hypervascular.
The right lobe of the liver is atrophic. B, There is an exophytic mass projecting off of the medial segment
of the left lobe, which is heterogeneous and contains multiple punctate calcifications.
After the patient’s history and results of radiologic
imaging studies were reviewed, surgical biopsy was
recommended. The rationale for surgical biopsy was
to obtain adequate tissue samples to establish a diagnosis
with absolute certainty and to allow visual inspection
of the multiple areas of involvement.
Fig. 2. Portal venous phase CT images of multiple FNH at multiple levels from superior to Inferior. A,
There is a large heterogeneous mass in the left lateral segment, which is predominantly hypodense to
normal liver. The adjacent medial left and right lobes are diffusely heterogeneous, containing multiple
hypodense lesions that are difficult to individually discriminate. B, Portal venous phase at the same level
as in Fig. 1, A. The exophytic lateral left segment lesion (*) is again seen, appearing more hypodense
to liver. A smaller hypodense lesion (**) is seen next to the gallbladder. Small hyperdense foci (arrowheads)
represent dilated hepatic veins. C, The inferior portion of the exophytic left lateral segment lesion is
seen (*). Another small left medial hypodense lesion (**) is evident, as are dilated hepatic veins (arrowhead).
D, The second large exophytic segment IV lesion (*) is evident, appearing more hypodense to liver with
unchanged foci of calcification.