title: Imaging of focal nodular hyperplastic-like nodules in alcoholic liver cirrhosis patients using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging.
abstract: We report on two patients with a history of alcohol abuse who presented with multiple hepatic nodules. Dynamic computed tomography revealed multiple nodular lesions, which were enhanced at the early contrast phase and washed out at the portal phase. In the hepatobiliary phase using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging (Gd-EOB-DTPA MRI), these tumors did not show any uptake, thus suggesting the presence of hepatocellular carcinoma. An ultrasound-guided biopsy revealed a slight increase in cell density, sinusoidal dilatation, and contained unpaired small arteries. According to immunohistochemical analyses, these arteries were positive for CD34 and alpha-smooth muscle actin. From these findings, the nodules were diagnosed to be focal nodular hyperplastic (FNH)-like nodules arising in alcoholic-cirrhosed livers. The differential diagnosis of FNH-like nodules arising in alcoholic liver cirrhosis and hepatocellular carcinoma is difficult with Gd-EOB-DTPA MRI, and therefore histological confirmation is necessary.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. miyaaki-hi@umin.ac.jp.
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Kawaguchi
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Kohno
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.affiliation: Department of Pathology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
keywords: Alcoholic liver cirrhosis; Focal nodular hyperplastic-like nodules; Gd-EOB-DTPA MRI