| Abstract: | These hepatic “tumours” occur with long-term contraceptive usage. Hepatic adenomas are more common than focal nodular hyperplasia. There is a high incidence of recurrent haemorrhage in hepatic adenomas, hence the need for resection. Focal nodular hyperplasia has no increased incidence of malignant transformation or haemorrhage. It may be multiple and show a characteristic angiographic appearance. One-third of these lesions will show sulphur colloid isotope uptake due to the presence of Kupffer cells. Hepatic adenomas show no isotope activity as these lesions lack Kupffer cells. The differentiation between focal nodular hyperplasia, hepatic adenomas, hepatomas and solitary metastases may be difficult as they may all be ultrasonographically echoic and, apart from some cases of focal nodular hyperplasia, show as defects on nuclear scanning. Usually hepatomas are less echoic than the normal liver substance, whereas metastases show at least some area of increased reflectivity especially if mucin producing. Angiography may indicate focal nodular hyperplasia, but the separation of the other three is often not possible short of tissue biopsy. |
