Clinical Images: Liver nodular regenerative hyperplasia in antisynthetase syndrome.

Abstract

in (1 anti – glycyl – transfer RNA synthetase antibody, proximal girdle high serum level of creatine phosphokinase, phenomenon of fi ngers, interstitial the progres-sive distention and bilateral lower extremities edematous change. A laboratory examination revealed elevated alanine aminotransferase (368 U/l) and aspartate aminotransferase (192 U/l) levels but a normal alpha-fetoprotein level (1.04 ng/ml). Abdominal computed tomography ( A : axial section, venous phase, slice thickness 5 mm; B : coronal reformatted section, venous phase, slice thickness 5 mm) numerous widespread hepatic enhancing nodules and massive ascites without any lymphadenopathy in the para-aortic retroperitoneum or pelvic cavity. hepatocellular carcinoma or liver metastasis was suspected. a liver biopsy showed sinusoidal dilatation but no malignant cell, signi fi cant lobular or portal in fl ammation, or advanced fi brosis by Masson trichrome Plasma not by a Mum1 stain. Iron stain and Congo red stain results were also negative. A reticulin stain of the ( thickened hepatic cell plates (arrows) compressing adjacent hepatocytes