14. Focal nodular hyperplasia

Page created on February 14, 2019. Last updated on February 18, 2022 at 14:28

Organ: Liver


On the front of the preparation can we see a well-circumscribed brownish lesion. The lesion has a central scar.

On the back of the preparation can we see a poorly circumscribed greyish lesion.

Diagnosis: Front: Focal nodular hyperplasia. Back: Liver metastasis


  • Focal nodular hyperplasia:
    • Oral contraceptive use


This preparation contains two different, unrelated lesions. On the front is the lesion of a focal nodular hyperplasia (FNH). FNH is the second most prevalent benign lesion of the liver, but unlike most other liver lesions, FNH is not due to neoplasia but rather hyperplasia (and as such is not considered a tumour in most cases). It has no malignant potential and is normally asymptomatic, so it’s usually not treated. FNH produces a lesion with a characteristic star-shaped scar in the centre.

The second lesion is on the back and is a liver metastasis.

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7 thoughts on “14. Focal nodular hyperplasia”

    1. The name of the preparation literally states that the metastasis is to liver, and the organ looks nothing like a lung. Are you sure it was the same preparation?

  1. Hey, I just wanted to say that you can’t really call this a neoplasm or a benign tumor, since it it’s hyperplasia. The definition of a tumor is that all the cells develop from one cell.

    1. You’re not wrong, but every source I can find except Robbins calls it a tumor, so I don’t see any harm in using that term. It is written in the theoretical topic that it is not a true neoplasm.

      1. My teacher said it was a liver hamartoma, would it be wrong to still call it a benign tumor? He also said that it had nothing to do with hyperplasia, they just used to think that it was hyperplasia and therefor named it that, but it turned out to be wrong.

        1. I’m definitely not one to argue about pathology with a pathologist, but the sources I find all state that FNH is a hyperplastic response to some vascular injury or problem in the liver.

          Robbins classifies it as a benign tumour, but UpToDate and StatPearls don’t use the term tumour at all, instead calling it a benign lesion. It depends on what one considers to be a tumour, I suppose. In any case, FNH is not a neoplasm.

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