PMC9257931_01
Non-contrast CT imaging of the chest revealed a multinodular ('patchy') pattern of the lesions in the hepatic parenchyma.
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Vascular structures (hepatic veins and portal branches) traversed the nodules without disruption (Figure 1).
Contrast-enhanced abdominal MRI demonstrated a multinodular ('patchy') appearance in the hepatic parenchyma: (a) T2-weighted image; (b) in-phase gradient echo image; (c) T2-FatSat-weighted image; (d) out-of-phase gradient echo image; (e) T1-weighted 3D gradient echo LAVA-flex sequence (post-gadolinium) and (f) subtracted image.
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The lesions demonstrated no contrast enhancement or diffusion restriction and there was no mass effect from the foci (Figure 2).
Sectioned slides. Macrovesicular globules of fat, inflammation in the area of the periportal tract, focal fibrosis (hematoxylin and eosin, x 100).
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More than 66% of hepatocytes were affected, which corresponded to third-degree macrovesicular (large droplet) steatosis (Figure 3) - a very pronounced steatosis, but at the same time, the inflammatory changes are moderate.