focal nodular hyperplasia

Summary

Summary: 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.

Top Publications

  1. Lizardi Cervera J, Cuéllar Gamboa L, Motola Kuba D. Focal nodular hyperplasia and hepatic adenoma: a review. Ann Hepatol. 2006;5:206-11 pubmed
    b>Focal Nodular Hyperplasia (FNH) and Hepatic Adenoma (HA) are a benign tumors of the liver. The association with the use of oral contraception in women in middle age has been mentioned...
  2. Sugito K, Uekusa S, Kawashima H, Furuya T, Ohashi K, Inoue M, et al. The clinical course in pediatric solid tumor patients with focal nodular hyperplasia of the liver. Int J Clin Oncol. 2011;16:482-7 pubmed publisher
    b>Focal nodular hyperplasia (FNH) of the liver is a rare benign lesion that may be related to the vascular and hepatic damage induced by completion of tumor therapy and a reaction to localized vascular abnormality...
  3. Cai Y, Gong L, Teng X, Zhang H, Wang C, Wei G, et al. Clonality and allelotype analyses of focal nodular hyperplasia compared with hepatocellular adenoma and carcinoma. World J Gastroenterol. 2009;15:4695-708 pubmed
    To identify clonality and genetic alterations in focal nodular hyperplasia (FNH) and the nodules derived from it. Twelve FNH lesions were examined...
  4. Gong L, Li Y, Su Q, Li G, Zhang W, Zhang W. Use of X-chromosome inactivation pattern and laser microdissection to determine the clonal origin of focal nodular hyperplasia of the liver. Pathology. 2009;41:348-55 pubmed publisher
    To determine the clonal origin of the whole lesion and each nodule of focal nodular hyperplasia (FNH) and elucidate its nature, simultaneously comparing the clonal composition with hepatocellular adenoma (HA)...
  5. Dietrich C, Schuessler G, Trojan J, Fellbaum C, Ignee A. Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol. 2005;78:704-7 pubmed
    Non-invasive differentiation of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is difficult...
  6. Nahm C, Ng K, Lockie P, Samra J, Hugh T. Focal nodular hyperplasia--a review of myths and truths. J Gastrointest Surg. 2011;15:2275-83 pubmed publisher
    b>Focal nodular hyperplasia (FNH) is a benign hyperplastic lesion of the liver with no known malignant potential. It has generated much interest due to the frequency with which it presents with atypical features on radiological imaging...
  7. Nuamah N, Hamaloglu E, Ozdemir A, Ozenc A, Sozseker C, Sokmensuer C. Hepatic focal nodular hyperplasia developing in a Fanconi anemia patient: a case report and literature review. Haematologica. 2006;91:ECR39 pubmed
    ..Histopathological examination of the mass after right hepatic lobectomy revealed focal nodular hyperplasia. This appears to be the first reported case of a hepatic focal nodular hyperplasia of such proportion ..
  8. Grazioli L, Bondioni M, Haradome H, Motosugi U, Tinti R, Frittoli B, et al. Hepatocellular adenoma and focal nodular hyperplasia: value of gadoxetic acid-enhanced MR imaging in differential diagnosis. Radiology. 2012;262:520-9 pubmed publisher
    To retrospectively evaluate the utility of gadoxetic acid-enhanced magnetic resonance (MR) imaging in the differential diagnosis of hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH).
  9. Rebouissou S, Bioulac Sage P, Zucman Rossi J. Molecular pathogenesis of focal nodular hyperplasia and hepatocellular adenoma. J Hepatol. 2008;48:163-70 pubmed
    b>Focal nodular hyperplasia (FNH) and hepatocellular adenomas (HCAs) are benign tumors that occur in otherwise normal liver parenchyma...

More Information

Publications62

  1. Di Carlo I, Pulvirenti E, Toro A, Priolo G. Adenoma or atypical hepatic focal nodular hyperplasia: role of preoperative imaging and laparoscopic treatment. Surg Laparosc Endosc Percutan Tech. 2010;20:e105-9 pubmed publisher
    Differentiation of focal nodular hyperplasia (FNH) and other hypervascular liver lesions, such as hepatocellular adenoma (HCA), is important because of the drastically different therapeutic approach...
  2. Piscaglia F, Venturi A, Mancini M, Giangregorio F, Vidili G, Magnolfi F, et al. Diagnostic features of real-time contrast-enhanced ultrasound in focal nodular hyperplasia of the liver. Ultraschall Med. 2010;31:276-82 pubmed publisher
    The typical appearance of focal nodular hyperplasia (FNH) in radiological contrast techniques (helical CT or MRI) includes homogeneous enhancement in the arterial phase, but the exact timing for the best visualization of this pattern is ..
  3. Trillaud H, Bruel J, Valette P, Vilgrain V, Schmutz G, Oyen R, et al. Characterization of focal liver lesions with SonoVue-enhanced sonography: international multicenter-study in comparison to CT and MRI. World J Gastroenterol. 2009;15:3748-56 pubmed
    ..0% (CEUS), 37.5% (CT) and 42.9% (MRI). The sensitivity and specificity of CEUS for the identification of focal nodular hyperplasia (FNH) and hemangiomas was 100% and 87%, resulting in an accuracy of 94.5%...
  4. Wilson S, Jang H, Kim T, Iijima H, Kamiyama N, Burns P. Real-time temporal maximum-intensity-projection imaging of hepatic lesions with contrast-enhanced sonography. AJR Am J Roentgenol. 2008;190:691-5 pubmed publisher
    ..Vascular morphology is depicted at a level or detail not seen before with sonography. High-frame-rate sequences of less than one second uniquely show arterial structure in liver lesions. ..
  5. Arts C, van Hillegersberg R, de Kort G, Moll F. Inferior caval vein thrombosis owing to compression of focal nodular hyperplasia: surgical resection after shrinkage by hepatic artery embolization. Vascular. 2010;18:53-8 pubmed
    The purpose of this study was to investigate the results of a staged treatment of symptomatic focal nodular hyperplasia (FNH), consisting of first embolization and then resection...
  6. Bartolotta T, Taibbi A, Matranga D, Malizia G, Lagalla R, Midiri M. Hepatic focal nodular hyperplasia: contrast-enhanced ultrasound findings with emphasis on lesion size, depth and liver echogenicity. Eur Radiol. 2010;20:2248-56 pubmed publisher
    To correlate contrast-enhanced ultrasound (CEUS) findings of hepatic focal nodular hyperplasia (FNH) with lesion size, depth and liver echogenicity and to compare CEUS with baseline US...
  7. Grazioli L, Morana G, Kirchin M, Schneider G. Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology. 2005;236:166-77 pubmed
    To prospectively determine the accuracy of differentiating benign focal nodular hyperplasia (FNH) from hepatic adenoma (HA) and liver adenomatosis (LA) by using gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging.
  8. Lin M, Tsay P, Ko S, Lui K, Tseng J, Hung C, et al. Triphasic dynamic CT findings of 63 hepatic focal nodular hyperplasia in 46 patients: correlation with size and pathological findings. Abdom Imaging. 2008;33:301-7 pubmed
    To correlate the dynamic computed tomography (CT) of hepatic focal nodular hyperplasia (FNH) with its size and pathology...
  9. Shanbhogue A, Prasad S, Takahashi N, Vikram R, Sahani D. Recent advances in cytogenetics and molecular biology of adult hepatocellular tumors: implications for imaging and management. Radiology. 2011;258:673-93 pubmed publisher
    b>Focal nodular hyperplasia (FNH), hepatocellular adenoma (HCA), and hepatocellular carcinoma (HCC) compose hepatocellular neoplasms that occur in adults...
  10. Zheng S, Cummings O, Saxena R, Zhang S, Wang M, Williamson S, et al. Clonality and TP53 mutation analysis of focal nodular hyperplasia of the liver. Am J Clin Pathol. 2010;134:65-70 pubmed publisher
    b>Focal nodular hyperplasia (FNH) is considered a benign tumor of the liver. However, the biologic nature and clonality status of FNH are not well established...
  11. Iyer A, Robert M, Bifulco C, Salem R, Jain D. Different cytokeratin and neuronal cell adhesion molecule staining patterns in focal nodular hyperplasia and hepatic adenoma and their significance. Hum Pathol. 2008;39:1370-7 pubmed publisher
    Differentiating focal nodular hyperplasia from hepatic adenoma can be challenging...
  12. Fujiwara H, Sekine S, Onaya H, Shimada K, Mikata R, Arai Y. Ring-like enhancement of focal nodular hyperplasia with hepatobiliary-phase Gd-EOB-DTPA-enhanced magnetic resonance imaging: radiological-pathological correlation. Jpn J Radiol. 2011;29:739-43 pubmed publisher
    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...
  13. Kim T, Jang H, Wilson S. Benign liver masses: imaging with microbubble contrast agents. Ultrasound Q. 2006;22:31-9 pubmed
    ..Most benign liver masses show characteristic features on CEUS, allowing an accurate diagnosis. This review article describes typical enhancement features of common benign liver masses. ..
  14. Mohajer K, Frydrychowicz A, Robbins J, Loeffler A, Reed T, Reeder S. Characterization of hepatic adenoma and focal nodular hyperplasia with gadoxetic acid. J Magn Reson Imaging. 2012;36:686-96 pubmed publisher
    ..of histologically proven hepatic adenoma (HA) as well as histologically and/or radiologically proven focal nodular hyperplasia (FNH) using delayed hepatobiliary MR imaging with 0.05 mmol/kg gadoxetic acid...
  15. Bieze M, van den Esschert J, Nio C, Verheij J, Reitsma J, Terpstra V, et al. Diagnostic accuracy of MRI in differentiating hepatocellular adenoma from focal nodular hyperplasia: prospective study of the additional value of gadoxetate disodium. AJR Am J Roentgenol. 2012;199:26-34 pubmed publisher
    ..of hepatobiliary phase gadoxetate disodium-enhanced MRI combined with standard MRI in differentiating focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA)...
  16. Magini G, Farsad M, Frigerio M, Serra C, Colecchia A, Jovine E, et al. C-11 acetate does not enhance usefulness of F-18 FDG PET/CT in differentiating between focal nodular hyperplasia and hepatic adenoma. Clin Nucl Med. 2009;34:659-65 pubmed publisher
    ..tomography (FDG PET) and C-11 acetate PET (AC PET) in distinguishing hepatic lesions due to consequential disease (hepatocellular adenoma and malignant lesions) from focal nodular hyperplasia (FNH) in patients at low risk of malignancy.
  17. Ahmad I, Iyer A, Marginean C, Yeh M, Ferrell L, Qin L, et al. Diagnostic use of cytokeratins, CD34, and neuronal cell adhesion molecule staining in focal nodular hyperplasia and hepatic adenoma. Hum Pathol. 2009;40:726-34 pubmed publisher
    ..Distinct staining patterns using these markers have been shown in resected specimens of focal nodular hyperplasia, telangiectatic focal nodular hyperplasia, and hepatic adenoma...
  18. Brancatelli G, Federle M, Vullierme M, Lagalla R, Midiri M, Vilgrain V. CT and MR imaging evaluation of hepatic adenoma. J Comput Assist Tomogr. 2006;30:745-50 pubmed
    ..The objective of our study was to illustrate the CT and MR imaging findings of hepatic adenoma. ..
  19. van den Esschert J, van Gulik T, Phoa S. Imaging modalities for focal nodular hyperplasia and hepatocellular adenoma. Dig Surg. 2010;27:46-55 pubmed publisher
    ..Differentiation between focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is important because of the consequences for management...
  20. Schmidt S, Saint Paul M, Anty R, Bruneton J, Gugenheim J, Chevallier P. [Multiple focal nodular hyperplasia of the liver associated with congenital absence of the portal vein]. Gastroenterol Clin Biol. 2006;30:310-3 pubmed
    ..32nd case of congenital absence of portal vein in an 18-year-old female adult associated with multiple focal nodular hyperplasia of the liver...
  21. Kobayashi S, Matsui O, Gabata T, Sanada J, Koda W, Minami T, et al. Radiological and histopathological manifestations of hepatocellular nodular lesions concomitant with various congenital and acquired hepatic hemodynamic abnormalities. Jpn J Radiol. 2009;27:53-68 pubmed publisher
    ..Most of these nodular lesions are benign hyperplastic nodules, such as focal nodular hyperplasia, nodular regenerative hyperplasia, and other types of regenerative nodules...
  22. Quaia E, Calliada F, Bertolotto M, Rossi S, Garioni L, Rosa L, et al. Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology. 2004;232:420-30 pubmed
  23. Handra Luca A, Paradis V, Vilgrain V, Dubois S, Durand F, Belghiti J, et al. Multiple mixed adenoma-focal nodular hyperplasia of the liver associated with spontaneous intrahepatic porto-systemic shunt: a new type of vascular malformation associated with the multiple focal nodular hyperplasia syndrome?. Histopathology. 2006;48:309-11 pubmed
  24. Buell J, Tranchart H, Cannon R, Dagher I. Management of benign hepatic tumors. Surg Clin North Am. 2010;90:719-35 pubmed publisher
    ..Surgery should be limited to symptomatic benign tumors or those who have a risk for complication (hemorrhage, rupture, or degeneration). When surgery is indicated, patients with benign disease are the best candidates for laparoscopy. ..
  25. Rebouissou S, Couchy G, Libbrecht L, Balabaud C, Imbeaud S, Auffray C, et al. The beta-catenin pathway is activated in focal nodular hyperplasia but not in cirrhotic FNH-like nodules. J Hepatol. 2008;49:61-71 pubmed publisher
    ..In FNH, increased activation of the beta-catenin pathway was found restricted to enlarged perivenous areas. FNH-like nodules may have a different pathogenetic origin. ..
  26. Huang D, Chen Y, Zeng Q, Zhao J, Wu R, Wu X, et al. Transarterial embolization using pingyangmycin lipiodol emulsion and polyvinyl alcohol for the treatment of focal nodular hyperplasia of the liver. Hepatogastroenterology. 2011;58:1736-41 pubmed publisher
    Surgical resection is the current treatment for focal nodular hyperplasia of the liver (FNH) when indicated. However, tumor location and size, patient comorbidities, and risk of complications may limit surgical options in some cases...
  27. Purysko A, Remer E, Coppa C, Obuchowski N, Schneider E, Veniero J. Characteristics and distinguishing features of hepatocellular adenoma and focal nodular hyperplasia on gadoxetate disodium-enhanced MRI. AJR Am J Roentgenol. 2012;198:115-23 pubmed publisher
    ..this study is to evaluate the performance of gadoxetate disodium-enhanced MRI in the characterization of focal nodular hyperplasia (FNH) and hepatocellular adenoma and to assess potential advantages of hepatocyte phase imaging in ..
  28. Bioulac Sage P, Balabaud C, Bedossa P, Scoazec J, Chiche L, Dhillon A, et al. Pathological diagnosis of liver cell adenoma and focal nodular hyperplasia: Bordeaux update. J Hepatol. 2007;46:521-7 pubmed
  29. van den Esschert J, Bieze M, Beuers U, van Gulik T, Bennink R. Differentiation of hepatocellular adenoma and focal nodular hyperplasia using 18F-fluorocholine PET/CT. Eur J Nucl Med Mol Imaging. 2011;38:436-40 pubmed publisher
    ..the use of PET/CT with (18)F-fluorocholine in the differentiation of hepatocellular adenoma (HCA) from focal nodular hyperplasia (FNH)...
  30. Donati F, Boraschi P, Gigoni R, Salemi S, Falaschi F, Bartolozzi C. Focal nodular hyperplasia of the liver: diffusion and perfusion MRI characteristics. Magn Reson Imaging. 2013;31:10-6 pubmed publisher
    To present diffusion and perfusion magnetic resonance imaging (MRI) characteristics of focal nodular hyperplasia (FNH) of the liver. Thirty-five patients with 52 FNHs (21 were pathologically-confirmed) underwent MRI at 1.5-T device...
  31. Reshamwala P, Kleiner D, Heller T. Nodular regenerative hyperplasia: not all nodules are created equal. Hepatology. 2006;44:7-14 pubmed
  32. Joyner B, Levin T, Goyal R, Newman B. Focal nodular hyperplasia of the liver: a sequela of tumor therapy. Pediatr Radiol. 2005;35:1234-9 pubmed
    b>Focal nodular hyperplasia (FNH) of the liver occurs with increased frequency in oncology patients after completion of tumor therapy. Its development may be related to the vascular damage induced by such therapy...
  33. Gouw A, Zeng W, Buiskool M, Platteel I, van den Heuvel M, Poppema S, et al. Molecular characterization of the vascular features of focal nodular hyperplasia and hepatocellular adenoma: a role for angiopoietin-1. Hepatology. 2010;52:540-9 pubmed publisher
    b>Focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) are two hepatic nodular lesions of different etiologies...
  34. Bartolotta T, Midiri M, Quaia E, Bertolotto M, Galia M, Cademartiri F, et al. Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography. Eur Radiol. 2005;15:1643-9 pubmed
    ..This review illustrates the spectrum of enhancement patterns of BFLL on contrast-enhanced ultrasonography with SonoVue, a second-generation microbubble-based contrast agent. ..
  35. Ibarrola C, Castellano V, Colina F. Focal hyperplastic hepatocellular nodules in hepatic venous outflow obstruction: a clinicopathological study of four patients and 24 nodules. Histopathology. 2004;44:172-9 pubmed
    ..as neoplastic (adenoma), regenerative (large regenerative nodule) or reactive to abnormal vasculature (focal nodular hyperplasia)...
  36. Grazioli L, Morana G, Federle M, Brancatelli G, Testoni M, Kirchin M, et al. Focal nodular hyperplasia: morphologic and functional information from MR imaging with gadobenate dimeglumine. Radiology. 2001;221:731-9 pubmed
    ..dimeglumine (Gd-BOPTA) is able to provide morphologic and functional information for characterization of focal nodular hyperplasia (FNH). Sixty-three consecutive patients with proved FNH were retrospectively examined...
  37. Brancatelli G, Federle M, Katyal S, Kapoor V. Hemodynamic characterization of focal nodular hyperplasia using three-dimensional volume-rendered multidetector CT angiography. AJR Am J Roentgenol. 2002;179:81-5 pubmed
    ..show the ability of three-dimensional multidetector CT angiography to display the angioarchitecture of focal nodular hyperplasia. CT angiography with volume rendering shows the anomalous feeding artery and hepatic draining veins that ..
  38. Cobey F, Salem R. A review of liver masses in pregnancy and a proposed algorithm for their diagnosis and management. Am J Surg. 2004;187:181-91 pubmed
    ..This paper presents an algorithm for the diagnosis and management of hepatic hemangiomas, focal nodular hyperplasia, liver cell adenomas and hepatocellular carcinoma associated with pregnancy based on our own experience ..
  39. Hussain S, Terkivatan T, Zondervan P, Lanjouw E, De Rave S, Ijzermans J, et al. Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis. Radiographics. 2004;24:3-17; discussion 18-9 pubmed
    b>Focal nodular hyperplasia (FNH) is the second most common benign liver tumor after hemangioma. FNH is classified into two types: classic (80% of cases) and nonclassic (20%)...
  40. Stanley G, Jeffrey R, Feliz B. CT findings and mistopathology of intratumoral steatosis in focal nodular hyperplasia: case report and review of the literature. J Comput Assist Tomogr. 2002;26:815-7 pubmed
    b>Focal nodular hyperplasia (FNH) is a benign hepatic lesion characterized by homogeneous enhancement following intravenous contrast. The authors report a patient with a markedly heterogeneous FNH due to extensive intratumoral fat.
  41. Paradis V, Benzekri A, Dargere D, Bieche I, Laurendeau I, Vilgrain V, et al. Telangiectatic focal nodular hyperplasia: a variant of hepatocellular adenoma. Gastroenterology. 2004;126:1323-9 pubmed
    quot;Telangiectatic focal nodular hyperplasia" designate atypical lesions considered as variants of focal nodular hyperplasia (FNH)...
  42. Ba Ssalamah A, Schima W, Schmook M, Linnau K, Schibany N, Helbich T, et al. Atypical focal nodular hyperplasia of the liver: imaging features of nonspecific and liver-specific MR contrast agents. AJR Am J Roentgenol. 2002;179:1447-56 pubmed
    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 ..
  43. Di Carlo I, Urrico G, Ursino V, Russello D, Puleo S, Latteri F. Simultaneous occurrence of adenoma, focal nodular hyperplasia, and hemangioma of the liver: are they derived from a common origin?. J Gastroenterol Hepatol. 2003;18:227-30 pubmed
    The association between hepatic hemangioma (HH) and focal nodular hyperplasia (FNH) or the association between FNH and hepatic adenoma (HA) has been reported...
  44. Paradis V, Bieche I, Dargere D, Laurendeau I, Nectoux J, Degott C, et al. A quantitative gene expression study suggests a role for angiopoietins in focal nodular hyperplasia. Gastroenterology. 2003;124:651-9 pubmed
    Although the pathogenesis of focal nodular hyperplasia (FNH) of the liver remains unclear, a vascular mechanism has been suspected...
  45. Mortele K, Praet M, Van Vlierberghe H, de Hemptinne B, Zou K, Ros P. Focal nodular hyperplasia of the liver: detection and characterization with plain and dynamic-enhanced MRI. Abdom Imaging. 2002;27:700-7 pubmed
    ..nonenhanced and dynamic gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) appearances of hepatic focal nodular hyperplasia (FNH) as depicted with breath-hold MR sequences and assessed the detectability of the individual MR ..
  46. Luciani A, Kobeiter H, Maison P, Cherqui D, Zafrani E, Dhumeaux D, et al. Focal nodular hyperplasia of the liver in men: is presentation the same in men and women?. Gut. 2002;50:877-80 pubmed
    b>Focal nodular hyperplasia (FNH) of the liver is a benign hepatic lesion relatively common in women. No studies specifically designed to describe the presentation and imaging findings in males have been published...
  47. Grazioli L, Morana G, Kirchin M, Caccia P, Romanini L, Bondioni M, et al. MRI of focal nodular hyperplasia (FNH) with gadobenate dimeglumine (Gd-BOPTA) and SPIO (ferumoxides): an intra-individual comparison. J Magn Reson Imaging. 2003;17:593-602 pubmed
    To compare the efficacy of two different MR contrast agents for the detection and diagnosis of focal nodular hyperplasia (FNH)...
  48. Vilgrain V, Boulos L, Vullierme M, Denys A, Terris B, Menu Y. Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics. 2000;20:379-97 pubmed
    ..Associated lesions include multiple hemangiomas, hemangiomatosis, focal nodular hyperplasia, and angiosarcoma...
  49. Scalori A, Tavani A, Gallus S, La Vecchia C, Colombo M. Risk factors for focal nodular hyperplasia of the liver: an Italian case-control study. Am J Gastroenterol. 2002;97:2371-3 pubmed
    Risk factors for focal nodular hyperplasia (FNH) of the liver are largely unknown, except for a possible role of female hormones. We evaluated the role of tobacco smoking and some lifestyle and dietary factors in its etiology...
  50. Terkivatan T, de Wilt J, de Man R, van Rijn R, Zondervan P, Tilanus H, et al. Indications and long-term outcome of treatment for benign hepatic tumors: a critical appraisal. Arch Surg. 2001;136:1033-8 pubmed
    ..The natural history and clinical behavior of benign hepatic tumors during long-term follow-up may not justify primary surgical treatment...
  51. Ruppert Kohlmayr A, Uggowitzer M, Kugler C, Zebedin D, Schaffler G, Ruppert G. Focal nodular hyperplasia and hepatocellular adenoma of the liver: differentiation with multiphasic helical CT. AJR Am J Roentgenol. 2001;176:1493-8 pubmed
    Differences of attenuation and enhancement patterns in focal nodular hyperplasia and hepatocellular adenoma were evaluated and quantified using triphasic single-slice helical CT.
  52. Belghiti J, Hiramatsu K, Benoist S, Massault P, Sauvanet A, Farges O. Seven hundred forty-seven hepatectomies in the 1990s: an update to evaluate the actual risk of liver resection. J Am Coll Surg. 2000;191:38-46 pubmed
    ..Because of this low basic risk, future studies evaluating resection on normal liver should not consider in-hospital mortality as the only end point. ..
  53. Dill Macky M, Burns P, Khalili K, Wilson S. Focal hepatic masses: enhancement patterns with SH U 508A and pulse-inversion US. Radiology. 2002;222:95-102 pubmed
    ..Responses were compared with confirmed diagnoses. Focal nodular hyperplasia was characterized by detectable vascularity and positive enhancement on interval-delay and postvascular ..