case_images: PMC10825960_01
case_images: PMC10825960_02
case_images: Abdominal radiographic and ultrasonographic examination (A-E). Right lateral (A) and ventrodorsal (B) radiographs of the abdomen. The caudoventral liver margins are rounded, and the gastric axis is deviated caudally. The liver parenchyma shows an irregular net-like, heterogeneously increased opacity. B-mode and color Doppler ultrasonographic images of the liver (C), near the left kidney (D), and peritoneal cavity (E). The hepatic parenchyma illustrates a uniformly increased echogenicity with reduced visualization of the portal structures (C). Numerous small tortuous vessels were observed near the left kidney (D) and accumulated a small amount of peritoneal fluid (E), asterisk.
case_images: fvets-10-1331392-g001.jpg
case_images: PMC10825960_02_fvets-10-1331392-g001.jpg
case_images: fig1
case_images: The hepatic opacity was heterogeneously increased net-like (Figures 1A,B). The result showed an enlarged liver with a uniformly increased echogenicity, fine echotexture, heterogeneous parenchyma (Figure 1C), increased echogenicity of the gall bladder wall without acoustic shadowing, multiple small tortuous vessels near the left renal and splenic regions with a small amount of peritoneal fluid (Figures 1D,E), and multiple diffuse hypoechoic nodular lesions in the spleen. No other remarkable findings in the peritoneal cavity were observed on ultrasound.
case_images: Transverse computed tomography images: pre-contrast (A-C) and post-contrast (D-F) images on a soft tissue algorithm. Generalized liver (A-C) and lymph node ((B,C), arrow heads) enlargement with increased attenuation compared with the splenic parenchyma. There were numerous varices in the left gastric vein (D), left renal (E), and colic region (F) (dotted line). LLL, left lateral lobe; LML, left medial lobe; RLL, right lateral lobe; RML, right medial lobe; QL, quadrate lobe; CP, caudate process of caudate lobe; PP, papillary process of caudate lobe; GB, gall bladder; RK, right kidney.
case_images: fvets-10-1331392-g002.jpg
case_images: PMC10825960_02_fvets-10-1331392-g002.jpg
case_images: fig2
case_images: The homogeneous increased parenchymal density was observed on all the liver lobes (Figures 2A-C). The left hepatic lobe was small, with a more prominent homogeneous increased parenchymal density (Figure 2A). The hepatic, splenic, and gastric lymph nodes were enlarged with marked increased parenchymal density, as observed in the pancreatic parenchyma (Figures 2B,C). On post-contrast images, there were numerous varices in the esophagus, left gastric vein, pancreaticoduodenal vein, left renal to splenic veins, and the mesenteric and colic regions (Figures 2D-F).
case_images: PMC10825960_03
case_images: PMC10825960_04
case_images: Laparoscopic photography (A) of the liver and histopathological findings after HE staining (B) and Prussian Blue staining (C) of the liver. The liver was diffusely yellow to tan and showed multifocal micro-nodulation macroscopically (A). There were marked abundant Kupffer cell clusters containing intracytoplasmic hemosiderin (B, x20), and Prussian Blue stain (C, x20) confirmed marked iron accumulation within the hepatocytes.
case_images: fvets-10-1331392-g003.jpg
case_images: PMC10825960_04_fvets-10-1331392-g003.jpg
case_images: fig3
case_images: On macroscopic evaluation, the liver was diffusely yellow to tan and enlarged with multifocal to coalescing micro-nodulations (Figure 3A). Histological examination of the liver biopsy samples confirmed marked vascular mural mineralization or calcification with portal vascular reduplication (Figure 3B). Prussian Blue staining showed marked iron accumulation within the hepatocytes in the regenerative nodules, interstitial septa, and groups of macrophages (Figure 3C).