Non-Alcoholic Steatohepatitis Presenting as Metastatic Liver Masses

Non-alcoholic steatohepatitis is a form of chronic hepatitis. Fatty degeneration may involve liver focally or as a whole. The patient was a 41-year-old woman who was diabetic and admitted in Buali hospital in Ghazvin because of right flank pain, fever, vomiting and diarrhea. The patient was treated as pyelonephriris. Liver function tests were as below: ALT: 62 (40) AST: 54 (40), Alkaline Phosohatase: 378 (306). Imaging study of liver and kidney showed multiple masses in liver that documented again in CT scan of abdomen. Liver biopsy was performed ultrasonography guided. Macrovesicular fatty changes were seen histologically and documented again by review of liver specimens. No any malignant structure was identified. The patient was treated as diabetic patients. Focal fatty infiltration can be misdiagnosed as liver metastasis; it is seen as nonspherical lesion in CT scan, without mass effect, with density similar to water. Guided biopsy of the liver can help to have the correct diagnosis.