Case report:

66-year-old male patient with a long-standing elevation of γ-GT since adolescence was referred for sonographic evaluation to exclude cholangiocellular carcinoma. B-mode ultrasound revealed an inhomogeneous liver parenchyma with diffusely distributed small comet-tail artifacts in the right liver lobe. The sonographic appearance was consistent with multiple biliary hamartomas (Von Meyenburg complexes). These consist of cysts, lined with biliary epithelium, and connective tissue, occur singly or in multiples, and typically measure 0.5–15 mm. Sonographically, they appear as echogenic nodules. To exclude malignancy-suspicious focal lesions, a contrast-enhanced ultrasound (CEUS) was performed. In correlation with the imaging findings and the known γ-GT elevation, there was no evidence of malignant liver disease. A single follow-up sonographic examination was scheduled.