PATHOPHYSIOLOGY

Focal Nodular Hyperplasia

Local hyperplastic response of normal hepatocytes

Arteriovenous shunt Localized hyperperfusion

Localized hemodynamic instability in the liver

Abdominal mass

Congenital Vascular Malformation

Predisposing Factors Female (80-95%) Age (30-50 years old)

Precipitating Factors No identified

precipitating factor

Abdominal pain

Stretching of the liver capsule or have a

mass effect on adjacent organs

NOTES:

FNH It is a proliferation of normal, nonneoplastic hepatocytes that are abnormally arranged

FNH is the second most common benign tumour of the liver after venous haemangioma

FNH is considered to be a non neoplastic lesion, benign condition without risk for

malignant transformation, and bleeding complications

FNH is now largely assumed as a hyperplastic pseudo-tumor

FNH is discovered in asymptomatic patients

FNH usually requires no treatment, except for very large or painful tumors

FNH can be diagnosed by computed tomography (CT) and Magnetic Resonance

Imaging (MRI)

FNH itself is not caused by or even associated with the use of oral contraceptives

Patients using oral contraceptives are more likely to present with symptoms, because

contraceptive use is often linked to tumor hemorrhage or infarction.

The pain is usually caused by larger lesions, which stretch the liver capsule or have a

mass effect on adjacent organs

DEFINITION OF TERMS:

Congenital Vascular Malformation - abnormally formed blood vessels that one is born

with

arteriovenous shunt  - abnormal communication between an artery and a vein; the

diversion of blood from an artery directly to a vein. Capillaries normally connect arteries

and veins

hyperperfusion - increased blood flow through an organ

hepatocytes – liver cells

hemodynamic instability - regional perfusion that is insufficient or excessive to

support normal organ function

hyperplastic - An abnormal increase in the number of cells in an organ or a tissue with

consequent enlargement.

Neoplastic - an abnormal new growth of tissue in animals or plants; a tumor