multiple FNH syndrome

Multiple focal nodular hyperplasia occurs in approximately 20-25% of patients with focal nodular hyperplasia (FNH). It is defined by The International Working Party as consisting of two or more FNHs in combination with :


Differential diagnosis 

Imaging differential considerations include:

  • multifocal HCC: can be a challenging differential
    • HCC has a true fibrotic capsule present in 60-80% of cases, but FNH may have a pseudocapsule composed of compressed parenchyma, perilesional vessels and inflammation
  • multiple hepatic adenomas: do not tend to have a central scar and majority of them contain fat
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