Focal nodular hyperplasia of the liver with angioma-like features in the center.

A 73-year-old woman was incidentally found to have a hypervascular nodule in the liver (S5) with imaging. She was subsequently followed under a diagnosis of suspected hepatic hemangioma because of continued enhancement in portal venous phase CT scan (Fig. 1A). Liver function test and tumor marker were within normal limits. Both HBs antigen and HCV antibody were negative. She had no history of taking oral contraceptives. Two years after the initial detection, the lesion appeared to be slightly enlarged, but imaging and biopsy studies failed to establish the diagnosis, and to exclude malignant tumors such as hepatocellular carcinoma. Thus, hepatic subsegmentectomy was performed. Grossly, the resected lesion was a hepatic subcapsular, welldemarcated, light yellow-whitish, solid nodule, 2 cm in diameter, with a central, dark-red, congestive area (Fig. 1B). Histologically, the nodular lesion showed mild hyperplasia of liver cells in contrast to the surrounding almost normal liver parenchyma; it contained fibrotic change with hyperplasia of arteriolae, vessels, and cholangioles (Fig. 1C). The central congestive area contained abundant angiomalike, CD34-positive small vascular spaces (Fig. 1D). These findings led to a diagnosis of focal nodular hyperplasia (FNH) of the liver with angioma-like features.