Expert: Neha Dahiya MD - 9/14/2009

Question
QUESTION: A focal tracer uptake in descending colon led to diagnosis of 1cm pedunclated polyp in descending colon 40 cm. from anal verge.Biopsy revealed moderate dysplasia.
A sol measuring 2.5/2 cms in segment VI of right lobe. FNAC revealed benign hepatocytes and biliary ductal epithelial cells. MRI indicated FNH.Have been advised repeat FNAC for SOL in liver and colonoscopy for colon after two months. Tumor marker tests normal.In case second FNAC also same, what will be done? Worried. Kindly advise.

ANSWER: Hello:

FNH or focal nodular hyperplasia of liver is a benign lesion and does not transform to liver cancer. So if the repeat FNA indicates that it is FNH nothing further needs to be done. surgical removal is very rarely required.

On the other hand the more serious diagnosis is of the polyp with dysplasia. Dysplasia is changes in cells which are not clearly normal nor do they have features to label them as cancer cells so they are in between. Such polyps carry a risk of cancer. Exactly how much increase in risk is there for moderate dysplasia is hard to say. Followup colonoscopy is best to check occurrence of new polyps.

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QUESTION: I had missed out mentioning that the size of sol in august was 2.0/1.5 on usg and after  25 days was measured as 2.5/2.ocms.on M.R.I. Does benign hepatocytes and biliary ductal epithelial cells in FNAC corelate to MRI finding of FNH?
Will another usg help the treatment prior to repeating FNAC?
AS regarding Polyp:I am indeed very grateful for the valuable opinion and guidance.Regards

Answer
Hi:

I am not an expert on MRI images so cannot say what the MRI findings are I can only comment on the FNA report. Only a person who has seen the original slides can correlate those findings by talking with the radiologist.

Minor variations in size measurement can be seen as the size is calculated by placing the cursor on the image.

An ultrasound would show if any major changes have occurred within or to the lesion