Multiple liver focal fat sparing lesions with unexpectedly increased (18)F-FDG uptake mimicking metastases examined by ultrasound (18)F-FDG PET/CT and MRI.

UNLABELLED

Focal fatty liver disease is less common than the diffuse form and may be misdiagnosed as nodular liver lesions or even liver metastases. Here, we report a 19 years old male, asymptomatic with liver lesions detected by ultrasound on routine examination. Further examinations with computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/CT (PET/CT) showed multiple lesions of varying sizes on the liver, with elevated fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake (SUVmax: 4.8-12.5). The diagnosis of metastases or lymphoma was made.

IN CONCLUSION

Histopathology diagnosed focal fatty sparing lesions in the liver. This pattern presented difficult diagnostic challenge. The pathogenesis of multifocal fat deposition and the reasons of the higher accumulation of (18)F-FDG in the liver fat lesions have not been up to now fully explained.