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Focal Nodular Hyperplasia (FNH)

The second most common benign liver tumor; usually requires no treatment.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Focal Nodular Hyperplasia (FNH)?

Focal nodular hyperplasia (FNH) is a benign lesion thought to develop as a hyperplastic response to abnormal arterial supply in the liver. It is the most common benign liver tumor after hemangioma and is usually seen in women of reproductive age.

Histologically, it is characterized by a central fibrous scar surrounded by nodular hepatocyte proliferation. The risk of malignant transformation or bleeding is essentially absent; distinguishing it from hepatocellular adenoma is critical for management.

Dynamic MRI typically demonstrates a central scar and arterial-phase hyperenhancement; biopsy is generally unnecessary.

Symptoms

Usually asymptomatic
Detected incidentally on imaging
Right upper quadrant fullness in large lesions
Mild right hypochondrial pain
Nausea and early satiety
Rarely a palpable mass
Liver tests are usually normal

Risk Factors

Female sex (reproductive age)
Use of oral contraceptives (weak association)
Pre-existing vascular anomaly in the liver
History of chemotherapy or radiotherapy
History of trauma
Hereditary hemorrhagic telangiectasia
Portal vein anomalies

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When a liver mass is detected on imaging
  • When the character of the lesion is uncertain
  • If new-onset right upper quadrant pain occurs
  • If the lesion grows rapidly
  • If liver function tests deteriorate

Treatment Methods

01
Observation is sufficient in asymptomatic cases (no treatment needed)
02
Dynamic MRI or contrast-enhanced ultrasound for definitive diagnosis
03
Use of oral contraceptives can usually be continued
04
Surgical resection in symptomatic large lesions
05
Rarely transarterial embolization
06
Differential diagnosis with biopsy in atypical lesions

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.