[Focal nodular hyperplasia of the liver: assessment of diagnosis and treatment in 31 patients in 15 years].
OBJECTIVE
Analysis of the diagnostic approach, therapy and management of focal nodular hyperplasia (FNH) of the liver.


METHODS
University Hospital Rotterdam-Dijkzigt, Rotterdam.


METHODS
Retrospective follow-up analysis.


METHODS
Medical records of patients with histologically proven FNH were analysed with respect to complaints, diagnostic approach and therapeutic management. Follow-up took place at the outpatient clinic where history-taking, physical examination, ultrasonography and hepatitis B and C serology tests were performed.


RESULTS
Thirty-one patients with histologically proven focal nodular hyperplasia were treated: 19 were treated conservatively, 12 underwent hepatic resection; one of these patients died postoperatively. Follow-up investigation was carried out in 16 and 9 patients, respectively. Laboratory results did not contribute to the diagnosis. Computed tomography was the most reliable imaging method; 71% of the lesions were correctly diagnosed. After a median follow-up of 52 months none of the patients treated conservatively showed tumour growth on ultrasonography.


CONCLUSIONS
The most efficient approach to confirm the diagnosis of focal nodular hyperplasia consists of an ultrasound-guided needle biopsy and histological examination of the specimen. Conservative management is the treatment of choice in focal nodular hyperplasia. Hepatic resection should only be performed in symptomatic patients, in case of tumour growth or of uncertain histological diagnosis, to exclude a malignant process.
de Wilt
J H
JH
Zuiderziekenhuis, afd. Algemene Heelkunde, Rotterdam.
de Man
R A
RA
Laméris
J S
JS
Ijzermans
J N
JN
D000328:Adult; D000465:Algorithms; D001706:Biopsy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006965:Hyperplasia; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies
Focale nodulaire hyperplasie van de lever: evaluatie van diagnostiek en behandeling bij 31 patiënten in 15 jaar.