Presentation
Incidental finding during work-up for acute abdominal pain.
Patient Data
The liver is echogenic consistent with hepatic steatosis. There are scattered, punctate, calcified granulomata with a comet tail artifact.
The cine loop demonstrates the calcified intrahepatic granulomata and the accompanying comet tail artifact.
Case Discussion
An example of the comet tail artifact due to punctate, calcified, intrahepatic granulomata.
The comment tail artifact may be identified when interrogating organs that demonstrate calcifications /calculi or crystals. Hence the artifact may be encountered when assessing renal and ureteric calculi, common bile duct stones, adenomyomatosis of the gallbladder, pancreatic calcifications, testicular microlithiasis, and colloid nodules within the thyroid gland.
They can also occur due to the presence of foreign bodies.
In this instance, the artifact is encountered in the liver due to the scattered and diffuse calcified granulomata and is well appreciated in the cine loop. In a tuberculosis-endemic local environment, the patient likely had previous micronodular hepatic tuberculosis.
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