PROGRESSIVE TYPE OF FOCAL NODULAR HYPERPLASIA CHARACTERIZED BY MULTIPLE TUMORS AND RECURRENCE

Focal nodular hyperplasia (FNH) is usually a stable lesion that does n ot enlarge when studied for long periods of time; recurrence after res ection has not been reported. We present a patient with a solitary FNH lesion that enlarged, was resected, and then recurred. A second resec tion was performed because of abdominal pain and disclosed multiple le sions, two of which were acutely infarcted. Thirty-two months later th ere was ultrasound evidence of further recurrence. Histology of the le sions showed the usual appearance of FNH with ducts and ductules in th e central stalk regions but also some areas with minimal ductular diff erentiation and scanty connective tissue. Because of the clinical and histological appearance, the lesions in this patient were distinct fro m the usual type of FNH and merit the name ''focal nodular hyperplasia , progressive type.''