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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2015; 69(1): 56–64. doi:doi: 10.14735/amgh201556.

A practical contribution to the diagnostics and treatment of focal nodular hyperplasia and adenomas in the liver from the perspective of a hepatologist, radiologist, pathologist and surgeon

Halima Gottfriedová  1, Eva Honsová  2, Darina Cupalová3, Dana Kautznerová  4, Lucie Morávková  5, Pavel Trunečka6, Julius Špičák  1, Martin Oliverius7

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Focal nodular hyperplasia and adenomas are benign hepatocellular lesions. The risk of life‑threatening bleeding and malignant transformation of adenomas require accurate diagnosis of both units and their differentiation not only from each other but also from other liver tumors. The progress in the area of imaging methods and particularly in the histopathological diagnosis leads to a more accurate differentiation using imaging methods, resection specimens and needle biopsies. Magnetic resonance imaging with a contrast medium plays an important role in the diagnostics, in the differentiation of adenoma subtypes and in the detection of adenoma complications; it also allows to establish differential diagnosis of focal nodular hyperplasia and adenoma. The use of genetic and immunohistochemical methods helps to distinguish adenoma subgroups with varying risk of hemorrhage and malignant transformation – this enables the application of an individualized surgical treatment in high risk adenomas and conservative treatment of small tumors with low risk of malignant transformation. The diagnosis is a result of a comprehensive assessment of the clinical and laboratory image, imaging methods and morphological evaluation. The therapeutic approach is individualized and requires multidisciplinary cooperation of experienced


liver adenoma, diagnosis, focal nodular hyperplasia, treatment, subtypes of adenomas

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