Presentation
Screening for HCC.
Patient Data
Age: 70 years
Gender: Male
From the case:
Diffuse steatosis with fibrosis mimicking a malignancy
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Liver showing irregular heterogeneous density in both lobes of liver.
From the case:
Diffuse steatosis with fibrosis mimicking a malignancy
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MRI showing classic geographic steatosis and fibrosis.
No mass was seen.
Liver biopsy was performed.
Histology
Steatohepatitis. The lobules show approximately 50% large droplet fatty change in a panacinar distribution with many ballooned cells. Portal fibrosis-patchy perisinusoidal fibrosis, periportal fibrosis with focal rare septa, confirmed by Trichrome stain.
Case Discussion
CT was mimicking more heterogeneity due to underlying fibrosis changes and was mimicking multi-nodular steatosis on CT scan. Liver biopsy confirmed a case of steatosis interspersed with fibrosis changes and lobular inflammation with lipogranulomas.
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