A 33-year-old woman has an incidental 4 cm liver lesion on ultrasound. MRI shows a central scar with radiating fibrous septa. Biopsy shows well-organized hepatocyte plates divided by fibrous bands containing numerous ductules and thick-walled aberrant arteries, with no true lobule architecture. What is the correct statement about this lesion?

• A It commonly transforms into hepatocellular carcinoma
• B It is strongly associated with oral contraceptive use
• C It arises from a developmental vascular anomaly and is not premalignant ✓
• D It typically contains mucin-producing columnar epithelium

Explanation

This is focal nodular hyperplasia, believed to arise as a hyperplastic response to a local arterial malformation, which explains the central scar and thick aberrant vessels. It is entirely benign and does not progress to cancer. Oral contraceptives promote growth of hepatocellular adenoma, not FNH, so option B confuses the two lesions. Ductular reaction within fibrous bands distinguishes it from adenoma, which lacks bile ducts.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.