Gastroenterology and hepatology: focal nodular hyperplasia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Gastroenterology and hepatology: focal nodular hyperplasia

Sample item

A 30-year-old woman has an incidental 4 cm liver lesion on CT. It is homogeneous, enhances brightly in the arterial phase and has a central stellate scar without calcification. She takes no hormones and liver enzymes are normal. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Focal nodular hyperplasia

Focal nodular hyperplasia is a benign hyperplastic response to an arterial malformation, with a central scar and no tendency to bleed or turn malignant. It needs no treatment in most patients. Fibrolamellar carcinoma has a heterogeneous mass with a calcified scar.

Option by option

  • A. Focal nodular hyperplasia (correct)

    Correct. A homogeneous arterial-enhancing lesion with a central scar is characteristic.

  • B. Cavernous haemangioma

    A haemangioma enhances from the periphery inwards in a nodular pattern.

  • C. Fibrolamellar carcinoma

    Fibrolamellar carcinoma is heterogeneous with a calcified scar and symptoms.

  • D. Hepatocellular adenoma

    Adenomas are heterogeneous, linked to oral contraceptives, and may bleed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Focal nodular hyperplasia. Focal nodular hyperplasia is a benign hyperplastic response to an arterial malformation, with a central scar and no tendency to bleed or turn malignant.

Why is "Cavernous haemangioma" not the answer?

A haemangioma enhances from the periphery inwards in a nodular pattern.

Why is "Fibrolamellar carcinoma" not the answer?

Fibrolamellar carcinoma is heterogeneous with a calcified scar and symptoms.

Why is "Hepatocellular adenoma" not the answer?

Adenomas are heterogeneous, linked to oral contraceptives, and may bleed.

What concept does this question test?

It tests Gastroenterology and hepatology: focal nodular hyperplasia in General Medicine. It needs no treatment in most patients. Fibrolamellar carcinoma has a heterogeneous mass with a calcified scar.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology and hepatology: focal nodular hyperplasia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.