Geographic steatosis mimicking a mass

Case contributed by Jayanth Keshavamurthy


Ultrasound performed for mildly elevated liver enzymes.

Patient Data

Age: 65 years
Gender: Male

Irregular area of hypoechogenicity in the liver without mass effect, likely geographic steatosis.. Recommend MRI for confirmation.

MRI confirms the sonogram findings of no mass effect and focal fatty sparing appearing as a pseudolesion.

Case Discussion

Look for mass effect and any vascular compromise when viewing a sonogram for lesion vs pseudolesion. MRI is useful to assess whether there is truly a mass or mass effect. In this case, the patient can be told to undertake lifestyle changes for steatosis and that no further workup is necessary.

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