BMJ Case Reports 2010; doi:10.1136/bcr.12.2009.2545
  • Images in…

A happy ending in hepatomegaly

  1. Deepak Suri3
  1. 1Department of General Medicine, The Whittington Hospital, London, UK
  2. 2Department of Histopathology, The Whittington Hospital, London, UK
  3. 3Department of Gastroenterology, The Whittington Hospital, London, UK
  1. Correspondence to Mark Samaan, mark{at}
  • Published 13 September 2010


A 48-year-old woman was referred to the gastroenterology outpatient department under the ‘2-week wait’ referral system for suspected cancer. She complained of a 5-week history of nausea, vomiting, anorexia and epigastric pain. The patient also felt she had lost weight but was unable to quantify this. On examination she had no stigmata of chronic liver disease but she had massive tender hepatomegaly to the right iliac fossa. Blood tests showed a bilirubin of 32 µmol/litre (normal range 0–21 µmol/litre) and an alanine transaminase of 59 IU/litre (Normal Range 0–31 IU/litre). The rest of her liver function tests, biochemistry and full blood count were normal. Her inflammatory markers were raised with a C reactive protein of 14 …

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