Archives of the AFIP -- RadioGraphics

Figure 14: FNH and hepatic adenoma in a 33-year-old woman with a history of oral contraceptive use. A hepatic mass had been discovered during laparoscopy performed as part of an infertility work-up. Panel A Unenhanced CT scan of the abdomen shows a mass (M) in the medial segment of the liver that displaces the middle hepatic vein. The attenuation of the mass is similar to that of the liver. Panel B On the CT scan obtained after intravenous administration of contrast material, the mass (M) enhances to the same degree as the adjacent liver. A subtle central scar (arrow) is seen. Biopsy was performed, and the lesion proved to be FNH. Panel C Unenhanced CT scan obtained at a more caudal level at the same time as a shows a low-attenuation mass (arrow) in the inferior aspect of the right lobe of the liver. Panel D On the contrast-enhanced scan, there is less enhancement of the mass (arrow) than of the adjacent hepatic parenchyma. This mass was the one noted at laparoscopy; at surgery, it proved to be an adenoma. Panel E Celiac angiogram shows a left lobe mass (white arrow) supplied by the tortuous middle hepatic artery, which courses through the center of the mass and produces a spoked-wheel appearance suggestive of FNH. The right lobe hepatic adenoma (black arrow) is peripherally vascular and is supplied by a branch of the right hepatic artery.

Return to: Differential Diagnosis