1. ¹Departement d'hémato-onco pédiatrie, Unité de transplantation médullaire, Université Henri Poincaré, Vandoeuvre-les–Nancy, France
2. ²Department de Radiologie, University of Nancy, Vandoeuvre-les–Nancy, France
3. ³Department of Paediatrics', University of Nancy, Vandoeuvre-les–Nancy, France
4. ⁴Department of Clinical Epidemiology, Centre d'Epidémiologie clinique CIC—CEC, Inserm CIE 6, University of Nancy, Nancy, France

Correspondence: Dr P Bordigoni and Dr H Sudour, Département d'hémato-onco pédiatrie et de transplantation médullaire, Université de Nancy, rue du Morvan, Vandoeuvre les Nancy 54511, France. E-mail: p.bordigoni@chu-nancy.fr

Received 13 May 2008; Revised 28 July 2008; Accepted 29 July 2008; Published online 22 September 2008.

Abstract

Incidental hepatic regenerating nodules rarely occur after haematopoietic SCT (HSCT). Focal nodular hyperplasia (FNH) is one of these unusual benign tumors with characteristic imaging features. To determine the incidence and the outcome of FNH of the liver and improve the understanding of its pathogenesis, we prospectively surveyed a total of 138 patients who had undergone serial prospective pre- and post-transplantation evaluations of iron biomarkers, including ferritin and liver iron concentration assessed by magnetic resonance imaging (MRI). Seventeen patients with a median delay of 6.4 years (2.2–13.6) developed FNH of the liver. All were children at the time of transplantation. MR images were typical for FNH in 16 patients; only one patient needed a confirmatory biopsy. Sixteen had received a myeloablative conditioning; six received a BU-based preparation and 10 TBI. Three patients experienced sinusoidal obstruction syndrome. Neither complication nor malignant transformation has been reported to date. FNH of the liver seems to be a frequent delayed benign complication following HSCT, probably of iatrogenic vascular origin. Basic clinical and diagnostic imaging follow-up is warranted.