case_images: PMC10844770_01
case_images: CT of the abdomen showing nodular liver contour with capsular retraction concerning for cirrhosis.
case_images: cureus-0016-00000051770-i01.jpg
case_images: PMC10844770_01_cureus-0016-00000051770-i01.jpg
case_images: FIG1
case_images: Preliminary imaging, including CT with IV contrast of the abdomen and pelvis, revealed a nodular liver contour concerning undiagnosed liver cirrhosis (Figure 1).
case_images: (A) MRI images showing confluent fibrosis in Segment VIII (red arrow) and lobulated liver contour (yellow arrows). (B) MRCP image showing gallbladder (a), right hepatic duct (b), left hepatic duct (c), common hepatic duct (d), common bile duct (e), pancreatic duct (f), and duodenum (g). The cystic duct is obscured by the small intestine. . MRCP: Magnetic resonance cholangiopancreatography
case_images: cureus-0016-00000051770-i02.jpg
case_images: PMC10844770_01_cureus-0016-00000051770-i02.jpg
case_images: FIG2
case_images: Additional imaging, including a magnetic resonance cholangiopancreatography (MRCP), showed lobulated hepatic contour without steatosis, iron deposition, and confluent fibrosis (Figure 2A-2B).
case_images: (A-C) Liver biopsy showing lymphocyte-predominant lobular disarray and portal inflammation with lymphoplasmacytic infiltrate and eosinophils. No evidence of PAS-positive/diastase-resistant globules, portal neutrophils, or significant fibrosis, suggesting an autoimmune process.. PAS: Periodic-acid Schiff stain
case_images: cureus-0016-00000051770-i03.jpg
case_images: PMC10844770_01_cureus-0016-00000051770-i03.jpg
case_images: FIG3
case_images: There was no evidence of parenchymal or mesenchymal iron deposition, periodic-acid Schiff stain (PAS)-positive/diastase-resistant globules, portal neutrophils, or significant fibrosis, suggesting an autoimmune process (Figure 3A-3B). 