Presentation
Incidental finding during general ultrasound.
Patient Data
Age: 55 years
Gender: Female
From the case:
Multiple biliary hamartomas
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Transverse

Liver ultrasound demonstrates multiple small foci with comet tail artifacts. With the high frequency transducer, a focus is located adjacent to a portal vein branch, indicating a possible biliary origin.
Case Discussion
Multiple small foci with comet tail artifact on ultrasound is a typical appearance for multiple biliary hamartomas. Other differentials to consider include: metastases, multiple abscesses, and calcifications. Other modalities such as MRI, would be helpful for further evaluation.