Hepatic focal fatty change in a chronic hepatitis C patient.

A 53-year-old patient with chronic hepatitis C virus infection was referred because of the presence of multiples ultrasonographic images simulating liver metastasis. Physical examination was normal. Liver function test showed increased levels of aminotransferases, high levels of γ-glutamyltransferase and normal alkaline phosphatase. Liver ultrasound identified multiples nodules that measured 0.5-2 cm in diameter, located in both lobules. Serum alpha-fetoprotein level was 13 ng/mL. A fine-needle aspiration cytology failed to reveal neoplastic cells. Liver biopsy showed chronic hepatitis, grading 7/18, staging 1/6 in Ishak score; moderate steatosis with multiples microlipogranulomas. This case illustrates an infrequent ultrasonographic presentation as well as a rare clinical entity, since fatty change of the liver is generally found as a diffuse process