Table 2.

Results of radiological investigation and subsequent liver biopsy in patient with marked liver dysfunction

Abdominal ultrasound scan	Enlarged liver, with marked fatty change No intrahepatic or common bile duct dilatation No focal liver lesions
CT liver	Hepatomegaly, with generalised low attenuation throughout. Splenomegaly, no cause identified
Liver biopsy	Severe extensive macrovesicular steatosis with marked lobulitis (Ishak grade 4/4) Some of the portal tracts show mild fibrous expansion (Ishak stage 1/6). Marked mixed inflammation in most of the portal tracts (Ishak grade 2/4) including numerous neutrophils, lymphocytes, plasma cells and eosinophils No bile duct loss or periductal fibrosis Features supporting a diagnosis of steatohepatitis Moderate fibrosis, not yet amounting to cirrhosis Well-formed Mallory-Denk bodies not seen. (Excluding a chronic picture)