[症例報告]Focal fatty change in the liver : Report of two cases which were difficult to distinguish from a neoplastic tumor in the liver

概要

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The presence of fatty change in the liver can be diagnosed by routine screening examinations, such as ultrasonography or computed tomography. However, when it takes a focal shape (focal fatty liver), an accurate diagnosis is not as easy as for diffuse fatty changes in the liver. In this report, we present two cases of focal fatty change of the liver which were finally diagnosed by biopsies. Ultrasonography showed an irregular hyperechoic area (2.5×2.2cm) located in the left median lobe (segment 4) of the liver in the first case, and an irregular hypoechoic area (2.3cm in diameter) located in segment 7 in the second case. Computed tomography (CT) and hepatic arterialangiography in case 1, CT and magnetic resonance imaging (MRI) in case 2 could not establish a final diagnosis. A final diagnosis of focal fatty change was only possible by means of a percutaneous fine needle biopsy in the first case and an open needle biopsy in the second. Regarding pathology, both regions contained various sized lipid droplets in the cytoplasm of the hepatocytes. In conclusion, these cases indicated that focal fatty change may not demonstrate any particular appearance using conventional diagnostic modalities, and therefore a needle biopsy is thought to be mandatory for making a differential diagnosis.
琉球医学会の論文
1997-00-00