Differential diagnosis between hepatic focal nodular hyperplasia and hepatocellular carcinoma with negative alhpa-fetoprotein.
OBJECTIVE
To study the differential diagnosis between hepatic focal nodular hyperplasia (FNH) and hepatocellular carcinoma (HCC) with negative alpha-feto protein.


METHODS
To analyse retrospectively the clinical and imaging materials of 18 patients with FNH and 254 patients with AFP negative HCC proven by operation and pathology during March 1996 to March 1999 in our institute.


RESULTS
Patients with FNH were largely younger (66.7% under 40 years), discovered accidentally (66.7%), and without hepatitis background (83.3%). Majority of them had a normal liver function (72.0%). A big central artery was found in the lesion with high velocity and low resistant index in 71.4% of patients by color Doppler ultrasound. CT scan showed transient immediate enhancement in 85.7% of patients after bolus injection, being homogeneous (53.3%) and isodensity (73.3%) in the portal vein phase. MR imaging demonstrated early vigorous enhancement (83.3%) and homogenous (66.7%) lesion. In contrast, patients with AFP negative HCC were generally older (85.8% over 40 years), with symptoms (74.0%). A color flow with high velocity and high resistant index was found by color Doppler ultrasound. CT scan showed early heterogenous enhancement (96.6%) after bolus injection and being hypodensity in portal vein phase. MR imaging indicated early heterogeneous enhancement (91.7%).


CONCLUSIONS
FNH shows some typical clinical and imaging features. Therefore, it is feasible to be differentiated from HCC with negative AFP in some of the patients.
Ye
Q
Q
Institute for Hepatic Carcinoma, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032, China.
Tang
Z
Z
Ma
Z
Z
Wu
Z
Z
Fan
J
J
Qin
L
L
Wang
W
W
D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins