Nuclear medicine: sulphur colloid and focal nodular hyperplasia: practice question

A Radiology 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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Radiology · Nuclear medicine: sulphur colloid and focal nodular hyperplasia

Sample item

A liver mass in a young woman is indeterminate on ultrasound. A Tc-99m sulphur colloid scan shows uptake equal to or greater than the adjacent liver. Which lesion is favoured?

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

The answer and the reasoning

C. Focal nodular hyperplasia

Focal nodular hyperplasia contains functioning Kupffer cells that take up sulphur colloid, so it may appear normal or hot. Adenomas, carcinomas and metastases mostly lack Kupffer cells and appear as cold defects. The finding is supportive rather than absolute.

Option by option

  • A. Metastasis

    Metastases appear as cold defects.

  • B. Hepatic adenoma

    Adenomas generally appear cold.

  • C. Focal nodular hyperplasia (correct)

    Correct. Kupffer cells in FNH take up colloid.

  • D. Hepatocellular carcinoma

    Hepatocellular carcinoma lacks Kupffer cells.

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.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Focal nodular hyperplasia. Focal nodular hyperplasia contains functioning Kupffer cells that take up sulphur colloid, so it may appear normal or hot.

Why is "Metastasis" not the answer?

Metastases appear as cold defects.

Why is "Hepatic adenoma" not the answer?

Adenomas generally appear cold.

Why is "Hepatocellular carcinoma" not the answer?

Hepatocellular carcinoma lacks Kupffer cells.

What concept does this question test?

It tests Nuclear medicine: sulphur colloid and focal nodular hyperplasia in Radiology. Adenomas, carcinomas and metastases mostly lack Kupffer cells and appear as cold defects. The finding is supportive rather than absolute.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Nuclear medicine: sulphur colloid and focal nodular hyperplasia?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.