Learning objectives
The aims of this pictorial review are:
to highlight the differential diagnosis of fat-containing hepatic lesions and their appearance using multimodality imaging
to serve as a learning tool for radiology trainees
to provide a histological correlation for some of these entities
Background
A variety of hepatic lesions,
ranging from benign to malignant entities can contain microscopic or macroscopic fat.
Focal fatty infiltration,
adenomas and focal nodular hyperplasia may contain intracellular lipid.
HNF 1α mutated adenoma and inflammatory adenoma usually contain intracellular fat.
Macroscopic fat-containing liver lesions include benign rare entities,
such as hepatic lipoma and teratoma and less rare lesions,
including hepatic angiomyolipoma.
Malignant lesions such as metastases from fat-containing tumours may also contain macroscopic fat.
A fat-containing nodule in a cirrhotic liver usually represents a well-differentiated...
Findings and procedure details
Liver lesions containing intracellular fat
Focal fat accumulation and diffuse fat accumulation with focal sparing
Hepatic steatosis is the result of deposition of fat in vacuoles within hepatocytes – it can be diffuse,
segmental,
or nodular.
Hepatic steatosis occurs in a number of conditions including excessive alcohol consumption,
insulin resistance,
obesity,
hyperlipidaemia,
viral infections (hepatitis B and hepatitis C) and secondary to the use of certain drugs including tamoxifen,
corticosteroids and antiretrovirals (1).
Focal fat deposition and focal sparing occur in characteristic areas includingthe gallbladder...
Conclusion
A proper radiological knowledge of the myriad of hepatic conditions that may demonstrate fat content,
enables a confident,
non-invasive diagnosis of multiple benign and malignant entities.
When necessary histopathological examination can then provide further guidance.
Personal information
Dr.
Veronica Attard
Basic specialist trainee
Medical Imaging Department
Mater Dei Hospital
[email protected]
Dr.
Luise Reichmuth
Specialist Registrar
Medical Imaging Department
Mater Dei Hospital
[email protected]
Dr.
James DeGaetano
Consultant Histopathology
Pathology Department,
Histology Section
Mater Dei Hospital
[email protected]
Dr.Kelvin Cortis
Consultant Hepatobiliary Diagnostic and Interventional Radiology
Medical Imaging Department
Mater Dei Hospital
[email protected]
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