Focal hepatic steatosis

Case contributed by Yahya Baba
Diagnosis certain


History of myeloproliferative neoplasm with multiple venous thromboembolism. CT follow-up.

Patient Data

Age: 55 years
Gender: Male

Sequelae of a chronic thrombosis of the left portal vein with atrophy of the left liver.

Poor opacification of the left hepatic vein.

Heterogenous hypodensity involving the right liver, without vessel or capsular distortion, in keeping with focal steatosis.

Heterogenous splenomegaly (160 mm) with peripheral hypodensities and capsular distortions (sequelae of splenic infarcts)

Sequelae of a chronic thrombosis of the splenic vein with development of portosystemic collateral pathways.

Left cortical renal scars. There is no thrombosis of the renal veins.

Case Discussion

Focal steatohepatitis is typically found in the medial segment of the left lobe (segment 4), which can be located either in front of the porta hepatis or next to the falciform ligament. But in this case, it involves almost the entire right liver, sparing the left lobe, probably due to the left portal vein thrombosis with subsequent low flow.

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