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Canadian Journal of Gastroenterology
Volume 15, Issue 2, Pages 137-142
Brief Communication

Multiple Focal Nodular Hyperplasia and Steatohepatitis: Atypical Imaging Characteristics

Robert P Myers,1 Dónal Downey,2 Subrata Chakrabarti,3 and Paul J Marotta1

1Department of Medicine, Liver Disease Unit, University of Western Ontario, London, Ontario, Canada
2Department of Radiology, University of Western Ontario, London, Ontario, Canada
3Department of Pathology, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Received 31 March 1999; Accepted 22 November 1999

Copyright © 2001 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Focal nodular hyperplasia is a rare, benign condition of the liver. A 28-year-old woman with malignant melanoma, mild liver enzyme abnormalities, steatohepatitis and newly documented hepatic lesions is described. Ultrasound, computed tomography and magnetic resonance imaging suggested only areas of focal fatty sparing but could not eliminate the concern for metastases. A 99mtechnetium-labelled sulphur colloid scan, however, revealed areas of increased uptake consistent with multiple focal nodular hyperplasia. This diagnosis was ultimately confirmed with a liver biopsy. The investigation of a patient with a malignancy and expanding hepatic lesions is challenging. This case illustrates the usefulness of the 99mtechnetium-labelled sulphur colloid scan in the evaluation of patients with hepatic lesions.