PMC2778349_01
Abdominal computed tomographic scanning through liver and spleen. Note the marked increase in liver density (113 Hounsfield units) compared to the spleen.
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About 18 months after taking amiodarone, liver enzymes were noted to have increased and computed tomographic (CT) scanning of the abdomen showed a significant increase in the density of the liver without contrast medium, compared to that of the spleen and surrounding tissues (113 Hounsfield units (H), normal range of the liver is about 30-70 H, Figure 1).
Photomicrographs of a liver biopsy. (a) Macrophages infiltrate into the portal area and contain achromatic fine granular depositions (arrows, hematoxylin, and eosin staining). (b) Fine granules are stained green in Leuco malachite green staining (arrows). Magnification, x400.
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The striking feature, however, was fine granular depositions in the macrophages that accumulated in the portal area (Figure 2(a)). Black B: black, Nile blue: blue, Schmorl: light blue (data not shown), and Leuco malachite green: green (Figure 2(b)). Based on these staining patterns, the fine granular depositions were considered to be lipopigments (ceroid and lipofuscin).
Normalization of CT density of the liver after 6-month discontinuation of amiodarone (63 Hounsfield units).
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Figure 3). Furthermore, amiodarone and desethylamiodarone became undetectable in the blood at about 6 months after cessation of amiodarone.