Multiple microfocal periportal steatosis mimicking hepatic metastases in statin liver injury.

Kolobanova E.S., Sergeeva O.N., Shorikov M.A., Frantsev D.Yu., Dolgushin B.I.

A case report of the atorvastatin induced cholestatic hepatitis appearing as microfocal peri-portal steatosis at diagnostic images is presented in the paper. After initial work-up, a hepatopancreatobiliary malignancy with liver metastases has been suspected. It’s a chal-lenge to distinguish minute perivascular fatty foci from metastatic lesions on US and CT im-ages; MRI is a reference method in such cases. Visualization and laboratory findings com-bined with careful anamnestic data acquisition resulted in a drug liver injury diagnosis. Atorvastatin uptake refusal led to performance status improvement, liver biochemistry test recovery and disappearance of periportal fatty lesions 3 months later; thus our guess has been confirmed. The presented case is intriguing from the point of visualization semiotics: as we know, it is a first report of statin liver injury appearing as small periportal fatty lesions mimicking hepatic metastases.

N.N. Blokhin National Medical Research Center of Oncology. Moscow, Russia.

Keywords: focal hepatosis, cholestatic hepatitis, jaundice, statin hepatitis, magnetic resonance imaging, MRI, MRCP, CT, periportal steatosis, liver metastases.

Corresponding author:  Kolobanova E.S., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Kolobanova E.S., Sergeeva O.N., Shorikov M.A., Frantsev D.Yu., Dolgushin B.I. Multiple microfocal periportal steatosis mimicking hepatic metastases in statin liver injury. REJR 2018; 8(4): 282-292. DOI:10.21569/2222-7415-2018-8-4-282-292.

Received:        20.11.18 Accepted:       12.12.18