[CLEAR Collier 1 case per day] Alcoholic cirrhosis with localized hepatic fat infiltration lesions misdiagnosed as liver cancer

Case Description:

The patient, male, 51 years old, was admitted to the hospital

The patient had no obvious triggers for dysregulation and fatigue 5 years ago, and was diagnosed with cirrhosis and ascites in the outer hospital, which was relieved

i.

Blood count: white blood cells 11.

Because the patient's hepatic mass lesions do not change much in 2 years, there is no obvious strengthening in the shadow of the enhanced mass, the AFP is not high, the possibility of liver cancer is small, combined with the background of alcoholic liver

Diagnosis is:

(1) Alcoholic cirrhosis,

(2) Hepatic mass (localized fat infiltration lesions?) Liver cancer?), because the patient's condition is poor, the family refuses to do liver puncture biopsy, so with the full and informed consent of the patient and the family, a small dose of hormone therapy (dexamethasone sodium phosphate injection 5 mg / day, pushed statically), and liver protection therapy: reductive glutathione (guladin) for injection 1.

Liver function was checked after one month of discharge: TBil15.

Figure 1

a: Flat liver CT scan and enhanced manifestations before and after treatment

b: In August 2011, CT enhancement and flat scan of the outer hospital showed 2.

c: Before treatment, ct scan shows low-density shading of 4.

d: Enhanced CT before treatment shows low density shadow without significant strengthening;

e: 3 weeks after hormonal therapy, CT flat scan before treatment of low-density shadow disappearance;

f: The patient's re-examination of CT after one month of discharge showed that the low-density shadow completely disappeared