Special Case CT

Medical history:
24 year old female patient with an isoechogenous mass, measuring 6 cm in diameter, in the left lobe of the liver. No symptoms. No previous hormone medication.

Typical CT finding of a focal nodular hyperplasia (FNH):
In the native scan this benign tumor appears to be almost isodense to the surrounding liver tissue; in its center a "scar" of lower density can be seen distinctly (top left image).
25 secs after contrast agent application, enhancement starts (top middle image), reaching its maximum after 30-40 secs (top right image). Note the typical delicate structure of the hypodense septae, which appear in a radial order.
After 45-60 secs, homogenous contrasting is reached (bottom left image); this is followed by a gradual decay in contrasting.
10 mins after contrast agent application the lesion appears to be hypodense to the surrounding liver tissue; the central scar shows discrete enhancement as well.

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