Limits...
CT guided biopsy of liver revealed pt has cirrhosis with corresponding portal hypertension. The biopsy of the liver mass was consistent with focal fat deposit, but inconclusive, and will be re-biopsied for definitive diagnosis

Patterson RAP - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CT guided biopsy of liver revealed pt has cirrhosis with corresponding portal hypertension. The biopsy of the liver mass was consistent with focal fat deposit, but inconclusive, and will be re-biopsied for definitive diagnosis

History: 49 y/o white male with a history of heavy EtOH use (3-4 hard dinks per day over past 35 years) complains of persistent bruising after two recent falls in which he did not lose consciousness. Pt reports yellowing of his skin and eyes, and a bloated abdomen over past five days. He has had several no bleeds in the past two days, and two black and tarry foul smelling stools. No episodes of hemoptysis

Findings: Ultrasound: Liver is echogenic with coarsened architecture and fatty infiltrate. There is a small mass in the left lobe. Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral. Liver appears diffusely fatty. Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices. A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm. The region has decreased uptake, which is consistent with focal fat deposit.

Ddx: With this patient’s history, clinical findings, and radiographic images, the differential is alcoholic hepatitis versus cirrhosis. Mass in the patient’s liver highly likely to be a hepatocellular carcinoma, but has a differential diagnosis of malignancy to include metastatic disease, and cholangiocarcinoma. A benign mass has the differential of a cyst, hemangioma, hepatic angioma, focal nodular hyperplasia, or an abcess.

Exam: Overweight jaundiced male with severe scleral icterus. He has a distended abd with a palpable liver edge 4cm below the costal margin. There is also shifting dullness to percussion. Pt also has mild bilateral edema in the lower extremities. Electrolytes- 139/2.9/101/26/11/0.8/122 Mg-1.6 Ca-7.4 CBC- 4.4/9/7/27.8/40 PT/PTT- 18.7/37.1 Alk Phos- 198 AST/ALT- 422/109 Tbili- 20.8 ConjBili- 16.8 LDH- 1066 Amylase- 201 Lipase-4353 AFP-5.6

No MeSH data available.


Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral.  Liver appears diffusely fatty.  Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices.  A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm.  The region has decreased uptake, which is consistent with focal fat deposit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=MPX2576&req=5

MPX2576_synpic24361: Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral. Liver appears diffusely fatty. Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices. A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm. The region has decreased uptake, which is consistent with focal fat deposit.


CT guided biopsy of liver revealed pt has cirrhosis with corresponding portal hypertension. The biopsy of the liver mass was consistent with focal fat deposit, but inconclusive, and will be re-biopsied for definitive diagnosis

Patterson RAP - MedPix

Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral.  Liver appears diffusely fatty.  Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices.  A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm.  The region has decreased uptake, which is consistent with focal fat deposit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2576&req=5

MPX2576_synpic24361: Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral. Liver appears diffusely fatty. Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices. A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm. The region has decreased uptake, which is consistent with focal fat deposit.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: CT guided biopsy of liver revealed pt has cirrhosis with corresponding portal hypertension. The biopsy of the liver mass was consistent with focal fat deposit, but inconclusive, and will be re-biopsied for definitive diagnosis

History: 49 y/o white male with a history of heavy EtOH use (3-4 hard dinks per day over past 35 years) complains of persistent bruising after two recent falls in which he did not lose consciousness. Pt reports yellowing of his skin and eyes, and a bloated abdomen over past five days. He has had several no bleeds in the past two days, and two black and tarry foul smelling stools. No episodes of hemoptysis

Findings: Ultrasound: Liver is echogenic with coarsened architecture and fatty infiltrate. There is a small mass in the left lobe. Triple phase contrast CT: Acites along the liver and pericolic gutter bilateral. Liver appears diffusely fatty. Evidence of portal hypertension such as cannulated umbilical artery, and esophageal varices. A hypoattenuated mass in the left lobe along the gallbladder fossa, which measures 6.1 x 4.5 cm. The region has decreased uptake, which is consistent with focal fat deposit.

Ddx: With this patient’s history, clinical findings, and radiographic images, the differential is alcoholic hepatitis versus cirrhosis. Mass in the patient’s liver highly likely to be a hepatocellular carcinoma, but has a differential diagnosis of malignancy to include metastatic disease, and cholangiocarcinoma. A benign mass has the differential of a cyst, hemangioma, hepatic angioma, focal nodular hyperplasia, or an abcess.

Exam: Overweight jaundiced male with severe scleral icterus. He has a distended abd with a palpable liver edge 4cm below the costal margin. There is also shifting dullness to percussion. Pt also has mild bilateral edema in the lower extremities. Electrolytes- 139/2.9/101/26/11/0.8/122 Mg-1.6 Ca-7.4 CBC- 4.4/9/7/27.8/40 PT/PTT- 18.7/37.1 Alk Phos- 198 AST/ALT- 422/109 Tbili- 20.8 ConjBili- 16.8 LDH- 1066 Amylase- 201 Lipase-4353 AFP-5.6

No MeSH data available.