History of FNH. ABDOMEN:LIVER, BILIARY TRACT: Mild fatty liver. Right hepatic lobe lobular mass measures approximately 10.3 x 9.8 cm demonstrating mildly heterogeneous mild T2 weighted hyperintensity. The mass is relatively isointense to liver parenchyma on T1-weighted imaging. It demonstrates fairly homogeneous arterial phase enhancement. The mass becomes relatively isointense to liver parenchyma on portal venous phase imaging. On delayed phase/redistribution imaging and hepatobiliary phase imaging at 10 minutes, 20 minutes and 1 hour it demonstrates relatively decreased signal intensity / uptake of hepatobiliary agent compared to the remainder of the liver parenchyma.The lesion displaces the anterior division of the right portal vein and abuts the posterior division.Small likely reactive porta hepatis lymph nodes.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Right hepatic lobe biopsy-proven FNH is not significantly changed in size measuring 10.3 x 9.8 cm with imaging features on delayed and hepatobiliary phase imaging suggesting an atypical focal nodular hyperplasia. Only 4 out 128 FNHs demonstrated hypointensity on delayed and hepatobiliary phase imaging in a previously published large cohort of liver lesions (Grazioli L, Morana G, Kirchin MA, Schneider G. Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine–enhanced MR imaging: prospective study. Radiology 2005;236(1):166–177.).