Hepatic adenoma vs Focal nodular hyperplasia
How to tell Hepatic adenoma and Focal nodular hyperplasia apart when a board question makes them look alike.
Adenoma is hormone-linked and can bleed; FNH is vascular-malformation related with central scar and minimal malignant concern.
Side by side
Benign hepatocellular tumor linked to oral contraceptives, anabolic steroids, glycogen storage disease, hemorrhage risk, and rare malignant transformation.
Benign hyperplastic liver lesion in young women with central stellate scar and usually no malignant potential.
Hormone-responsive clonal hepatocyte proliferation creates a vascular tumor prone to bleeding.
Localized hyperplastic response to abnormal arterial blood flow produces nodular hepatocyte growth around a central scar.
Solitary hypervascular lesion in estrogen or anabolic steroid exposure, especially with pain or hemorrhage, supports hepatic adenoma.
Central scar on imaging with otherwise benign course and normal AFP supports focal nodular hyperplasia.
The trap
Both are benign liver lesions in young women, so exposure history and central scar decide the answer.
Watch it explained
Test it nowThe repair move
For benign liver masses, ask whether the risk is hormone-linked bleeding or central-scar hyperplasia.
Try a free question
CoreA 28-year-old woman taking estrogen-containing oral contraceptives has sudden right upper quadrant pain from hemorrhage into a benign hepatocellular liver tumor. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Hepatic adenoma. Hormone-linked benign hepatocyte tumor with hemorrhage risk is hepatic adenoma.
Why the other choices are tempting
- B. FNH is classically a central-scar lesion and usually lacks hemorrhage or malignant concern.
- C. Hemangioma is a benign vascular lesion but is not the classic OCP-linked bleeding hepatocyte tumor.
- D. Cholangiocarcinoma is malignant bile duct cancer with obstructive jaundice.
- E. A simple cyst does not explain hormone-linked hemorrhage into a hepatocellular tumor.
Flashcards
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What exposure points to hepatic adenoma?
Oral contraceptive or anabolic steroid exposure points to hepatic adenoma.
What imaging clue points to focal nodular hyperplasia?
A central stellate scar points to focal nodular hyperplasia.
Quick answers
What is the fastest way to tell Hepatic adenoma from Focal nodular hyperplasia?
Adenoma is hormone-linked and can bleed; FNH is vascular-malformation related with central scar and minimal malignant concern.
What is the key clue for Hepatic adenoma?
Benign hepatocellular tumor linked to oral contraceptives, anabolic steroids, glycogen storage disease, hemorrhage risk, and rare malignant transformation.
What is the key clue for Focal nodular hyperplasia?
Benign hyperplastic liver lesion in young women with central stellate scar and usually no malignant potential.
What is the common trap with Hepatic adenoma vs Focal nodular hyperplasia?
Both are benign liver lesions in young women, so exposure history and central scar decide the answer.