Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation

Following liver transplantation (LT), recipients can develop benign and malignant hepatic masses just like any other patient. Patients transplanted for hepatocellular carcinoma (HCC) undergo surveillance imaging, and any new mass seen on imaging must be carefully evaluated to rule out recurrent canc...

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Main Authors: Christina S. Gainey, Suzanne L. Palmer, Edward Mena, Navpreet Kaur, Yuna Gong, Jeffrey A. Kahn
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Transplantation
Online Access:http://dx.doi.org/10.1155/2020/8824099
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author Christina S. Gainey
Suzanne L. Palmer
Edward Mena
Navpreet Kaur
Yuna Gong
Jeffrey A. Kahn
author_facet Christina S. Gainey
Suzanne L. Palmer
Edward Mena
Navpreet Kaur
Yuna Gong
Jeffrey A. Kahn
author_sort Christina S. Gainey
collection DOAJ
description Following liver transplantation (LT), recipients can develop benign and malignant hepatic masses just like any other patient. Patients transplanted for hepatocellular carcinoma (HCC) undergo surveillance imaging, and any new mass seen on imaging must be carefully evaluated to rule out recurrent cancer. Focal nodular hyperplasia (FNH) is a benign tumor of the liver that most often occurs in women and is rarely symptomatic. It is important to distinguish FNH from more serious etiologies, such as recurrent HCC and other malignancies, since the treatments differ greatly. To date, there have been very few reports of FNH occurring in a liver allograft. We present a case of a patient with a history of a carcinoid tumor who underwent LT for HCC. Several years posttransplant, the patient was found to have a liver mass with classic features of HCC on imaging. The liver biopsy revealed the unexpected diagnosis of FNH. This finding avoided unnecessary treatment for HCC, which is associated with morbidity, especially in the posttransplant setting. We present our diagnostic approach, discuss the clinicopathologic and imaging findings of FNH, and review the literature on FNH in the posttransplant setting.
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spelling doaj-art-d018a526c59a4e83ad6387839b22c58c2025-08-20T02:20:03ZengWileyCase Reports in Transplantation2090-69432090-69512020-01-01202010.1155/2020/88240998824099Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver TransplantationChristina S. Gainey0Suzanne L. Palmer1Edward Mena2Navpreet Kaur3Yuna Gong4Jeffrey A. Kahn5Department of Internal Medicine, LAC+USC Medical Center, Keck School of Medicine of USC, USADepartment of Radiology, Keck School of Medicine of USC, USACalifornia Liver Research Institute, Pasadena, CA, USADepartment of Surgery, University of Southern California, Los Angeles, CA, USADepartment of Clinical Pathology, Keck School of Medicine of USC, USADivision of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, USAFollowing liver transplantation (LT), recipients can develop benign and malignant hepatic masses just like any other patient. Patients transplanted for hepatocellular carcinoma (HCC) undergo surveillance imaging, and any new mass seen on imaging must be carefully evaluated to rule out recurrent cancer. Focal nodular hyperplasia (FNH) is a benign tumor of the liver that most often occurs in women and is rarely symptomatic. It is important to distinguish FNH from more serious etiologies, such as recurrent HCC and other malignancies, since the treatments differ greatly. To date, there have been very few reports of FNH occurring in a liver allograft. We present a case of a patient with a history of a carcinoid tumor who underwent LT for HCC. Several years posttransplant, the patient was found to have a liver mass with classic features of HCC on imaging. The liver biopsy revealed the unexpected diagnosis of FNH. This finding avoided unnecessary treatment for HCC, which is associated with morbidity, especially in the posttransplant setting. We present our diagnostic approach, discuss the clinicopathologic and imaging findings of FNH, and review the literature on FNH in the posttransplant setting.http://dx.doi.org/10.1155/2020/8824099
spellingShingle Christina S. Gainey
Suzanne L. Palmer
Edward Mena
Navpreet Kaur
Yuna Gong
Jeffrey A. Kahn
Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
Case Reports in Transplantation
title Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
title_full Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
title_fullStr Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
title_full_unstemmed Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
title_short Diagnosis of Focal Nodular Hyperplasia (FNH) after Liver Transplantation
title_sort diagnosis of focal nodular hyperplasia fnh after liver transplantation
url http://dx.doi.org/10.1155/2020/8824099
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AT suzannelpalmer diagnosisoffocalnodularhyperplasiafnhafterlivertransplantation
AT edwardmena diagnosisoffocalnodularhyperplasiafnhafterlivertransplantation
AT navpreetkaur diagnosisoffocalnodularhyperplasiafnhafterlivertransplantation
AT yunagong diagnosisoffocalnodularhyperplasiafnhafterlivertransplantation
AT jeffreyakahn diagnosisoffocalnodularhyperplasiafnhafterlivertransplantation