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MRI of Atypical Focal Nodular Hyperplasia of the Liver: Radiology–Pathology Correlation

Sophie Ferlicot1,2, Hicham Kobeiter3, Jeanne Tran Van Nhieu1, Daniel Cherqui4, Daniel Dhumeaux5, Didier Mathieu3 and Elie Serge Zafrani1

1 Département de Pathologie, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris et Université Paris 12-Val de Marne, Créteil 94010, France.
2 Service d'Anatomie Pathologique, Centre Hospitalier Universitaire de Bicêtre, 78 rue du Général Leclerc, Le Kremlin-Bicêtre, Cedex 94275, France.
3 Service d'Imagerie Médicale, Hôpital Henri Mondor, Créteil 94010, France.
4 Service de Chirurgie Digestive, Hôpital Henri Mondor, Créteil 94010, France.
5 Service d'Hépatologie et de Gastroentérologie, Hôpital Henri Mondor, Créteil 94010, France.



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  		Fig. 1. —43-year-old woman with focal nodular hyperplasia. Spin-echo T2-weighted image shows 6-cm lesion (arrows) in segment VII of liver, displacing both right hepatic vein and inferior vena cava. Lesion is heterogeneous in posterior part and slightly hyperintense with no central scar. Microscopically, lesion showed hyperplastic nodules with no stellate area or thick fibrous septa.

 


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  		Fig. 2A. —46-year-old woman with focal nodular hyperplasia. Spin-echo T1-weighted image shows slightly heterogeneous lesion (arrow) in left lobe. Lesion contains central hypointense scar (arrowhead).

 


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  		Fig. 2B. —46-year-old woman with focal nodular hyperplasia. Contrast-enhanced spin-echo T1-weighted image obtained 4 min after bolus injection reveals persistent hypointensity of central scar (arrowhead).

 


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  		Fig. 3. —37-year-old woman with focal nodular hyperplasia. Spin-echo T2-weighted image shows hyperintense and heterogeneous round lesion (arrow) of left lobe, with round highly hyperintense area in its center. Microscopically, lesion showed large area of hemorrhagic necrosis within hepatic nodule.

 


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  		Fig. 4A. —22-year-old woman with focal nodular hyperplasia of left lobe. Spin-echo T1-weighted image shows slightly hyperintense foci (arrows) circumscribing lesion.

 


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  		Fig. 4B. —22-year-old woman with focal nodular hyperplasia of left lobe. Fat-suppressed spin-echo T1-weighted image reveals persistent hyperintensity of lesion (arrows).

 


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  		Fig. 5. —39-year-old woman with focal nodular hyperplasia of left lobe. Spin-echo T2-weighted image shows hyperintense rim (arrow) simulating capsule around lesion. This peripheral rim was hypointense on T1-weighted sequences and corresponded to compressed adjacent liver tissue on histology examination.

 

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