Presentation
It occasionally presents with abdominal pain. In our series, three patients presented with self-limiting abdominal pain (spontaneous resolution), and a palpable mass was found only in case 2. [analesdepediatria.org]
Abstract An autopsy case, 59-year old woman, of idiopathic portal hypertension with hepatic nodular hyperplasia and intra- and extrahepatic portal vein thrombosis was presented. [jstage.jst.go.jp]
May present with severe, acute abdominal pain with bleeding into the abdomen, leading to shock. Other rare presentations include obstructive jaundice. [patient.info]
Also, a literature review is presented. Resumo: Neste trabalho apresentamos um caso de hiperplasia nodular focal que foi diagnosticado aos seis anos de idade e que está sendo acompanhado até o momento presente. [rb.org.br]
Presentation A 35 -year-old woman with a history of oral contraception presents with right upper quadrant pain. Caption: B-mode gray scale imaging Description: Transabdominal ultrasound shows a mass in the right lobe of the liver. [sonoworld.com]
Entire Body System
- Pathologist
Despite this, unusual well-differentiated lesions can pose significant diagnostic issues even among liver pathologists. [e-cmh.org]
A pathologist studies the specimen under a microscope, in order to make a definitive diagnosis Many clinical conditions may have similar signs and symptoms. [dovemed.com]
The diagnosis of a cholangiocarcinoma is often difficult to make for a radiologist and even a pathologist. That is because cholangiocarcinoma has a varied morphology and histology. [radiologyassistant.nl]
This group usually includes a hepatologist, transplant and or liver surgeon, abdominal radiologist, interventional radiologist, and pathologist. The AASLD has development guidelines for the treatment of patients with HCC. [clinicaladvisor.com]
Cardiovascular
- Hypertension
Although definite etiology of idiopathic portal hypertension in this case was not revealed, the possible causes were discussed. [jstage.jst.go.jp]
[…] portal or pulmonary hypertension 7 The origin of FNH is thought to be due to a hyperplastic growth of normal hepatocytes with a malformed biliary draining system, possibly in response to a pre-existent arteriovenous malformation 1,4. [radiopaedia.org]
Because of the limitations of organ supply, liver transplantation is generally reserved for patients with unresectable tumors either due to location or presence of portal hypertension. [clinicaladvisor.com]
To K76.89 K76.0 Fatty (change of) liver, not elsewhere classified K76.1 Chronic passive congestion of liver K76.2 Central hemorrhagic necrosis of liver K76.3 Infarction of liver K76.4 Peliosis hepatis K76.5 Hepatic veno-occlusive disease K76.6 Portal hypertension [icd10data.com]
The pathophysiological mechanisms underlying neurological decline include venous hypertension, ischemia and a mass effect due to the typically hugely dilated venous structures. The current clinical case has several major points of interest. [em-consulte.com]
Workup
However, during the abdominal workup, B-mode ultrasound examination showed several focal liver lesions, ranging from 1–5.4 cm in size. Endoscopy and colonoscopy showed no primary gastrointestinal tumor. [em-consulte.com]
Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol. 2009;15(26):3217–3227. 16. Ronot M, Vilgrain V. Imaging of benign hepatocellular lesions: current concepts and recent updates. [dovepress.com]
Assy N, Nasser G, Djibre A, Beniashvili Z, Elias S, Zidan J: Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol 2009;15:3217–3227. [karger.com]
Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol. 2009;15:3217–27. [eurjmedres.biomedcentral.com]
Treatment
General Practice Notebook General Practice Notebook The information provided herein should not be used for diagnosis or treatment of any medical condition. [gpnotebook.co.uk]
Coverage of the entire breadth and depth of gastroenterology ranges from biology to pathobiology, as well as diagnosis and treatment of diseases of the gastrointestinal, pancreatic, and hepatobiliary systems. [books.google.com]
Treatment is rarely needed. Hemangiomas are usually small and asymptomatic; they occur in 1 to 5% of adults. [merckmanuals.com]
Treatment options for HCC can be either curative or palliative. There is now substantial research data confirming the effectiveness of treatments for HCC. [clinicaladvisor.com]
Conservative treatment is often sufficient Surgical treatment if symptomatic and/or complications arise For hepatic adenoma Discontinue oral contraceptives If the tumor is > 5 cm → surgical resection due to increased risk of rupture, bleeding, or malignant [amboss.com]
Prognosis
Most often these subtypes do not affect treatment or prognosis (outlook). But one of these subtypes, fibrolamellar, is important to recognize. It is rare, making up less than 1% of HCCs and is most often seen in women younger than age 35. [cancer.org]
Treatment and prognosis FNH is benign, with no malignant potential and a minuscule risk of complication (rupture, hemorrhage) and thus are usually treated conservatively 1. [radiopaedia.org]
Its clinical manifestations are diverse and usually seen distal to the SCAVS site, and its prompt diagnosis and management will make for a better neurological prognosis. [em-consulte.com]
Prognosis and treatment Two main complications can affect HCA: hemorrhage and malignant transformation in HCC [ 53 - 55 ]. Even if rare, these events are difficult to predict and potentially life-threatening. [e-cmh.org]
Etiology
Although definite etiology of idiopathic portal hypertension in this case was not revealed, the possible causes were discussed. [jstage.jst.go.jp]
Etiology of Increased Uptake The cause of the relatively increased Tc-99m sulfur colloid uptake in focal nodular hyperplasia, as opposed to hepatic adenoma, remains controversial. [med.harvard.edu]
The etiology of hepatic adenomatosis is largely unknown, but there are good arguments to suppose a shared disease mechanism with HA [ 42 ]. [karger.com]
Epidemiology Frequency: hepatic hemangioma (most common) > focal nodular hyperplasia ( FNH ) > hepatocellular adenoma (rare) Sex: ♀ > ♂ (∼ 6:1) Age: can appear at any age, but mostly affects young women Most often an incidental finding on imaging tests Etiology [amboss.com]
(Etiology) Focal Nodular Hyperplasia of the Liver is believed to be caused by congenital abnormalities in the liver blood vessels. [dovemed.com]
Epidemiology
Epidemiology HA is usually diagnosed in young females using oral contraceptives. Incidence and prevalence of HA are not exactly known. [karger.com]
Benign liver tumors General Epidemiology Frequency: hepatic hemangioma (most common) > focal nodular hyperplasia ( FNH ) > hepatocellular adenoma (rare) Sex: ♀ > ♂ (∼ 6:1) Age: can appear at any age, but mostly affects young women Most often an incidental [amboss.com]
[…] noncirrhotic liver Immunoreactivity for glutamine synthetase with a map-like pattern of staining Terminology Also known as focal cirrhosis, pedunculated adenoma, solitary hyperplastic nodule, mixed adenoma, hamartoma and hamartomatous cholangiohepatoma Epidemiology [pathologyoutlines.com]
Changing epidemiology of hepatocellular adenoma in the United States: review of the literature. Int J Hepatol 2013;2013:604860. 24. Rooks JB, Ory HW, Ishak KG, Strauss LT, Greenspan JR, Hill AP, et al. Epidemiology of hepatocellular adenoma. [e-cmh.org]
Definition and epidemiology The term focal nodular hyperplasia (FNH), which was coined by Edmondson in 1958 [1], refers to a relatively common benign hepatic tumor. [ncbi.nlm.nih.gov]
Pathophysiology
[…] these lesions may be multiple or can occur as part of a syndrome with hemangiomas, epithelioid hemangioendothelioma, hepatic adenomas, fibrolamellar hepatocellular carcinoma, vascular malformations of the brain, meningiomas, and/or astrocytomas. [1] Pathophysiology [en.wikipedia.org]
Pathophysiology FNH most probably arises as a reaction to local hemodynamic instability in the liver. [karger.com]
This concludes this unit on pathophysiology of the liver. Now you can go on to Specific Liver Diseases. Brief Quiz on what you have just covered >> < Liver Menu [vet.uga.edu]
We describe here in detail this rare case of multiple FNH syndrome associated with lung and spinal arteriovenous malformations (AVM), and briefly discuss the possible pathophysiology underlying the association of these apparently unrelated lesions. [em-consulte.com]
[…] occurrence in childhood More common in females than males (F:M = 8:1) Accounts for ~8% of all primary liver tumors in adults ( Dig Surg 2010;27:24 ) Prevalence of 4 - 30 per 1,000 in adults and 0.2 per 1,000 in persons < 18 years ( Dig Surg 2010;27:24 ) Pathophysiology [pathologyoutlines.com]
Prevention
When doctors discover a large adenoma, they may recommend that it be surgically removed to prevent that possibility. [liverfoundation.org]
Moderation in alcohol, medications and fat intake must be observed to prevent straining the liver. Of the right part of the liver is affected, the gallbladder may also be removed. [diseaseszoom.com]
[…] atypical FNH into several variants which include 8 : telangiectatic variant: most common mixed hyperplastic and adenomatous variant lesions with large cell hepatocellular atypia As FNH is usually treated conservatively, accurate imaging is essential in preventing [radiopaedia.org]
To prevent miscalculation from technical differences, a size change of ≤10% was not considered as growth or regression. [ijri.org]