A rare sign of portal hypertension.

Abstract

A 44-year-old male with previous medical history of alcoholism, obesity, hypertension and goiter performed diagnostic work-up consistent with alcoholic liver cirrhosis. Blood tests revealed thrombocytopenia (plate- let count 47x10^9/L) and mild elevation of aspartate aminotransferase, alanine aminotransferase and gamma- glutamyl transferase levels. Albumin, bilirubin and coa- gulation studies were normal. Abdominal ultrasound revealed splenomegaly and, remarkably, multiple puncti- form hyperechogenic foci could be seen dispersed within splenic parenchyma (Figure 1). What is your diagnosis?