Abstract

Focal fatty change (FFC) may occur in the form of a single or numerous nodules of different size, located in the liver with otherwise normal structure. These changes, especially when they are large and single, pose an important diagnostic problem as their clinical and radiological picture may imitate malignancy. In the paper we report two cases of large hepatic tumors (12 cm and 8 cm) in patients, who had no factors predisposing to fatty liver changes (such as alcohol abuse, drugs, obesity, hormone disturbances, impaired blood flow through the liver or metabolic disturbances). In microscopic examinations the nodules were diagnosed as foci of large-droplet hepatocellular steatosis. Apart from these changes the liver was normal. CONCLUSION: FFC belongs to a group of pseudotumor changes. It occurs in rare cases and should be distinguished from diffuse changes observed frequently. In the differential diagnosis, the following must also be considered: primary hepatocellular tumors with fatty change, FNH with fatty change, mesenchymal tumors containing adipose tissue, fatty macro-regenerative nodule, adipocytic pseudotumor of the Glisson's capsule.