title: Multiple hypervascular liver nodules in a heavy drinker of alcohol.
abstract: A case of hypervascular nodules in the liver, but without hepatitis B or C virus infection in a 38-year-old woman with a history of alcohol abuse is presented. An ultrasound disclosed 1-2-cm hypoechoic tumors in the right and left lobes. Magnetic resonance imaging showed high-intensity tumors at both the T1-weighted and T2-weighted sequences. Incremental dynamic computed tomography and hepatic angiography revealed hypervascular tumors. Ultrasound-guided needle biopsy revealed no evidence of hepatocellular carcinoma, metastatic liver cancer, hemangioendothelioma, inflammatory pseudotumors or pseudolymphoma, but demonstrated stellate-scar fibrosis septa, which contained small unpaired arteries without hyperplasia dividing the nodule. Moreover, marked pericellular fibrosis, neutrophilic infiltration and Mallory bodies were observed in the cytoplasm. There was no evidence of bile duct proliferation. From these findings, the diagnosis of alcohol-induced fibrosis, distinctly different from focal nodular hyperplasia, was tenable. Further studies may provide insights into the pathogenesis of nodule formation and hypervascularity in heavy drinkers of alcohol.
authors.affiliation: Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Yoko
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Keiji
authors.initials: K
authors.lastname: Mita
authors.forename: Kwansong
authors.initials: K
authors.lastname: Ku
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Koterazawa
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nakajima
authors.forename: Katsumi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Miyuki
authors.initials: M
authors.lastname: Nakaji
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Ke Ih
authors.initials: KI
authors.lastname: Kim
authors.forename: Midori
authors.initials: M
authors.lastname: Hirai
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply*; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging* / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography