Multiple hypervascular liver nodules in a heavy drinker of alcohol.
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.
Kim
Soo Ryang
SR
Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
Maekawa
Yoko
Y
Ninomiya
Toshiaki
T
Imoto
Susumu
S
Matsuoka
Toshiyuki
T
Ando
Kenji
K
Mita
Keiji
K
Ku
Kwansong
K
Koterazawa
Toshihiro
T
Nakajima
Taisuke
T
Fukuda
Katsumi
K
Yano
Yoshihiko
Y
Nakaji
Miyuki
M
Kudo
Masatoshi
M
Kim
Ke Ih
KI
Hirai
Midori
M
Hayashi
Yoshitake
Y
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