Focal nodular hyperplasia is best described as hyperplasia with which feature?

• A. Isoechoic pattern with central scar
• B. Hyperplasia with central radiating stellate scar
• C. Central scar absent
• D. Peripheral fibrous capsule

Answer: (B)

Focal nodular hyperplasia is a benign liver lesion that forms as a hyperplastic response to a local vascular anomaly. The feature that best describes it is a central scar that is radiating stellate in appearance. This central scar represents fibrous tissue with Septa that extend outward from the center, creating a star-like pattern. It’s this combination of a central fibrous scar with radiating fibrous bands that is the hallmark of FNH. On imaging, the scar often demonstrates delayed enhancement because fibrous tissue takes up contrast more slowly than the surrounding hepatocytes, helping distinguish FNH from other liver lesions. While some FNH lesions may have a capsule, the defining characteristic remains the central radiating scar.