{"id":7515,"date":"2022-11-22T13:00:22","date_gmt":"2022-11-22T10:00:22","guid":{"rendered":"https:\/\/urbancare.clinic\/multifocal-nodular-steatosis-mimicking-malignancy\/"},"modified":"2022-11-22T13:00:22","modified_gmt":"2022-11-22T10:00:22","slug":"multifokale-nodulare-steatose-die-ein-malignom-vortauscht","status":"publish","type":"post","link":"https:\/\/urbancare.clinic\/de\/multifocal-nodular-steatosis-mimicking-malignancy\/","title":{"rendered":"Multifokale nodul\u00e4re Steatose, die ein Malignom vort\u00e4uscht"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/multifocal-nodular-steatosis-mimicking-malignancy.jpg\" class=\"ff-og-image-inserted\" style=\"display:none\"><\/div>\n<p><span class=\"highwire-journal-article-marker-start\"><\/span><\/p>\n<p id=\"p-1\">Ein zuvor fitter Mann stellte sich mit Atemnot vor. Die R\u00f6ntgenaufnahme des Brustkorbs zeigte eine Dichte des rechten Unterlappens. Leberfunktionstests, Gerinnungsstudien und Alphafetoprotein-Spiegel waren unauff\u00e4llig. Die Atemlosigkeit des Patienten verschwand von selbst, aber eine Brust-Bauch-Becken-CT, die zum Ausschluss einer Malignit\u00e4t durchgef\u00fchrt wurde, ergab mehrere hypodense Leberl\u00e4sionen, die Metastasen bef\u00fcrchten lie\u00dfen (Abbildung 1). Eine ultraschallgesteuerte perkutane Leberbiopsie, die auf diese L\u00e4sionen abzielte, wurde erfolgreich durchgef\u00fchrt. Die Histologie zeigte eine Fettver\u00e4nderung, aber keinen Hinweis auf eine Malignit\u00e4t. Um die M\u00f6glichkeit einer Probenahme zu vermeiden \u2026 <\/p>\n<p><span class=\"highwire-journal-article-marker-end\"><\/span><a href=\"http:\/\/pmj.bmj.com\/cgi\/content\/short\/98\/1166\/e33?rss=1\">Medizinische t\u00e4gliche Quelle<\/a><\/p>\n<p>","protected":false},"excerpt":{"rendered":"<p>Ein zuvor gesunder Mann stellte sich mit Atemnot vor. Die R\u00f6ntgenaufnahme des Brustkorbs zeigte eine Dichte des rechten Unterlappens. Leberfunktionstests, Gerinnungsstudien und Alphafetoproteinwerte waren unauff\u00e4llig. Die Atemnot des Patienten verschwand von selbst, aber eine CT des Brust-Abdomen-Beckens, die zum Ausschluss einer malignen Erkrankung durchgef\u00fchrt wurde, ergab mehrere hypodense Leberl\u00e4sionen, die auf Metastasen hindeuten (<cross-ref type=\"fig\" refid=\"F1\">Abbildung 1<\/cross-ref>). Eine ultraschallgesteuerte perkutane Leberbiopsie zur Untersuchung dieser L\u00e4sionen wurde erfolgreich durchgef\u00fchrt. Die Histologie zeigte eine Fettver\u00e4nderung, aber keinen Hinweis auf eine Malignit\u00e4t. Um die M\u00f6glichkeit eines Probenentnahmefehlers auszuschlie\u00dfen, wurde eine zweite ultraschallgesteuerte Biopsie der L\u00e4sionen durchgef\u00fchrt. Auch hier wurde kein malignes Gewebe identifiziert. Es wurde eine MRT der Leber durchgef\u00fchrt (<cross-ref type=\"fig\" refid=\"F2\">Abbildung 2A,B<\/cross-ref>). Die gegenphasigen Bilder zeigten einen Signalausfall in der Mitte der L\u00e4sionen (<cross-ref type=\"fig\" refid=\"F2\">Abbildung 2B<\/cross-ref>), was auf einen intrazellul\u00e4ren Lipidgehalt hinweist und auf eine steatotische Ver\u00e4nderung schlie\u00dfen l\u00e4sst. Bei dem Patienten wurde eine multifokale nodul\u00e4re Steatose (MNS) diagnostiziert, er wurde beruhigt und entlassen.<\/p>\n<p>MNS-L\u00e4sionen k\u00f6nnen schwierig von metastasierenden Erkrankungen zu unterscheiden sein, weil sie \u2026<\/p>","protected":false},"author":2,"featured_media":7516,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"Default","format":"standard","meta":{"page_builder":"","fifu_image_url":"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/multifocal-nodular-steatosis-mimicking-malignancy.jpg","fifu_image_alt":"","footnotes":""},"categories":[185],"tags":[],"class_list":["post-7515","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-medical-articles"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Multifocal nodular steatosis mimicking malignancy - Urban Care Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbancare.clinic\/de\/multifokale-nodulare-steatose-die-ein-malignom-vortauscht\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Multifocal nodular steatosis mimicking malignancy - Urban Care Clinic\" \/>\n<meta property=\"og:description\" content=\"A previously fit man presented with breathlessness. Chest radiography showed right lower lobe density. Liver function tests, coagulation studies and alphafetoprotein levels were unremarkable. The patient&#039;s breathlessness self-resolved, but chest&ndash;abdomen&ndash;pelvis CT performed to exclude malignancy revealed multiple hypodense liver lesions concerning for metastases (figure 1). Ultrasound-guided percutaneous liver biopsy targeting these lesions was successfully carried out. Histology showed fatty change but no evidence of malignancy. To avoid the possibility of sampling error, a second ultrasound-guided biopsy of the lesions was performed. Again, no malignant tissue was identified. MRI of the liver was performed (figure 2A,B). The out-of-phase images showed signal drop-out in the middle of the lesions (figure 2B), indicative of intracellular lipid content and suggestive of steatotic change. The patient was diagnosed with multifocal nodular steatosis (MNS), reassured and discharged. MNS lesions can be difficult to distinguish from metastatic disease because they...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/urbancare.clinic\/de\/multifokale-nodulare-steatose-die-ein-malignom-vortauscht\/\" \/>\n<meta property=\"og:site_name\" content=\"Urban Care Clinic\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/urbancarezanzibar\" \/>\n<meta property=\"article:published_time\" content=\"2022-11-22T10:00:22+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/urbancare.clinic\/wp-content\/uploads\/2023\/02\/multifocal-nodular-steatosis-mimicking-malignancy.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"1024\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Urban Care Clinic\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Urban Care Clinic\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/\"},\"author\":{\"name\":\"Urban Care Clinic\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#\\\/schema\\\/person\\\/a304a61bcf298680ee41e2e9ae193930\"},\"headline\":\"Multifocal nodular steatosis mimicking malignancy\",\"datePublished\":\"2022-11-22T10:00:22+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/\"},\"wordCount\":81,\"publisher\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/urbancare.clinic\\\/wp-content\\\/uploads\\\/2023\\\/02\\\/multifocal-nodular-steatosis-mimicking-malignancy.jpg\",\"articleSection\":[\"Research Articles\"],\"inLanguage\":\"de\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/\",\"url\":\"https:\\\/\\\/urbancare.clinic\\\/multifocal-nodular-steatosis-mimicking-malignancy\\\/\",\"name\":\"Multifocal nodular steatosis mimicking malignancy - 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