Unusual Lesions of the Liver

A 57-year-old man was referred to our hospital because of lesions of the liver discovered as an accidental finding on a magnetic resonance imaging (MRI) of the heart. The MRI was performed because of complaints of dyspnea. His further history revealed autism. At the time of presentation he had no symptoms. Physical examination showed no abnormalities. Routine laboratory results were unremarkable. An MRI of the liver was performed. This showed multiple, cystic lesions scattered diffusely through the liver. These lesions had low signal intensity on T1-weighted images (Figure A), intermediate to high signal intensity on T2-weighted images (Figure B). Some of the lesions showed a variable degree of contrast enhancement after application of gadolinium (arrows). These findings in combination with the clinical background were suggestive of biliary hamartomas. A liver biopsy confirmed the diagnosis (Figure C). Histology analysis revealed slightly dilated structures, lined by cuboidal epithelium embedded in fibrous stroma. The epithelium expressed biliary-type cytokeratin 7.

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