How does one differentiate FNH from fibrolamellar hepatocellular carcinoma on cross sectional imaging

How does one differentiate FNH from fibrolamellar hepatocellular carcinoma on cross sectional imaging?

Fibrolamellar HCC is a rare form of HCC that typically affects young adults and can mimic the imaging appearance of FNH. However, some cross-sectional imaging features that may be useful to help differentiate between them are as follows:

  • • FNH is typically small in size (<5 cm) and homogeneous, whereas fibrolamellar HCC is typically large in size and heterogenous.
  • • The central scar of FNH is hyperintense on T2-weighted images and noncalcified, whereas the central scar of fibrolamellar HCC is hypointense on T2-weighted images and sometimes calcified.
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