矢島 義昭, 桜田 弘之

Yoshiaki YAJIMA, Hiroyuki SAKURADA

仙台市立病院消化器科

Department of Gastroenterology, Sendai City Hospital

キーワード : Focal Fatty Change, Hepatic Porphyria

A 45-year-old woman was referred to our hospital for the precise examination of mass lesions in the liver. She had a past history of blood transfusion and showed a slight liver dysfunction. Both HBsAg and Anti-HCV were negative and the AFP level was 3 ng/ml. An ultrasound examination revealed multiple round hyperechoic lesions in the S₅ of the liver. A CT scan showed several low-density lesions in the same region of the liver. An echo-guided fine-needle liver biopsy showed a dense distribution of large fatty droplets around the central vein. These fatty droplets were Sudan-III stain positive, indicating the accumulation of triglyceride. Focal fatty change, like this case, was recently reported to have been seen in hepatic porphyria. In this case, however, porphyrin bodies were not present in the urine and the biopsied specimen did not show red fluorescence under ultraviolet by fluorescence microscopy.