Analysis Of The Clinical Characteristics, Diagnosis And Treatment Of Focal Nodular Hyperplasia

Objective: To summarize the clinical features of focal nodular hyperplasia(FNH), in order to improve the understanding of FNH.Methods:A retrospective study was used, collecting ninety-one cases with surgical pathology diagnosis of FNH, all of which were from March 2005 to December 2014 in the Affiliated Union Hospital of Fujian Medical University. Statistical software applied in describing the characteristics of these cases, including demography, clinical manifestation, auxiliary examination results, lesion distributions and surgical method.Results: Ninety-one patients with a median age of 34 years(M/F ratio 49/42)were mainly discovered during imaging procedures for unrelated symptoms(91.7%). γ-glutamyl transaminase(GGT) elevated in 33.0% of patients, and alanine aminotransferase(ALT) elevated in 14.3% of patients. MRI with a sensitivity of 60.3%, while CT and Color Doppler US with a sensitivity of 43.8% and 32.9%, respectively. FNH is solitary in 92.3% of the cases, and exophytic in 52.5% of the cases. Central scars were diagnosed in 32.7% of the cases. The longest diameter is less than three centimeters in 38.6% of cases. Laparoscopic hepatectomy performed in 11.0% of the cases(limited hepatectomy performed in five cases and hepalobectomy performed in five cases), open hepatectomy performed in 89.0% of the cases( limited hepatectomy performed in sixty-six cases and hepalobectomy performed in fifteen cases). The mean operation blood loss amount is 109.2±95.7ml. Complications occurred in 9.9% of the cases, and no perioperative mortality was observed. Among the causes of resection in FNHs, 61% of cases had indefinite preoperative diagnoses, which retained the possibilities of malignant tumor. In another 30% of the cases, the patients were overburdened with the scruple of the lesions’ pathological types. The patient with abdominal pain and the patient had to perform cholecystectomy take 1% of the cases, respectively.Conclusions: Focal nodular hyperplasia frequently develops in youth. Male is slightly more than female in this series. FNH usually appear as solitary, exophytic lesions, with the longest diameter less than three centimeters. Compared with CT and Color Doppler US, MRI has the best sensitivity in the diagnosis of FNH. Limited hepatectomy or regular hepatectomy usually performs in FNH.