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

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