FNH vs Hepatic Adenoma: Key Differences
Focal nodular hyperplasia (FNH) and hepatic adenoma are benign liver lesions seen more often in women. They can look similar on imaging, but their risk of bleeding and malignant transformation, and therefore their management, differ.
FNH
A lesion typically with a central scar, largely independent of hormones. The risk of bleeding and malignant change is very low, and most are observed.
Hepatic adenoma
May be linked with oral contraceptives, anabolic steroids and obesity. Carries a risk of bleeding and, rarely, malignant transformation; surgery is considered especially in lesions >5 cm or in male patients.
Diagnosis
- Hepatocyte-specific contrast MRI is the most useful tool for differentiation
- Biopsy may be needed in equivocal cases
Management
FNH is usually observed; adenoma management depends on size, sex and subtype, with hormonal triggers stopped and surgery in selected cases.
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