"Skip areas" in focal steatosis describes a newly proposed "subsegmental type" of focal steatosis, which differs in both extent and topography from the more classic "lobar or segmental type" of focal steatosis. In the subsegmental type of steatosis, fatty infiltration can be considered homogeneous throughout the liver, with the exception of small flattened portions of less affected parenchyma, called "skip areas." These regions are mainly located in the subcapsular areas or along the interlobar fissures or the gallbladder bed. Observations using ultrasound in vivo, as well as on postmortem in vitro angiograms, suggest that both the extent and topography of these skip areas can be explained by local differences in vascular anatomy.
The origin of the sonographic halo sign in liver metastases was studied after autopsy in 33 livers with macroscopic tumoral involvement. For 20 lesions a detailed comparison of findings from high-resolution 7.5- and 10-MHz sonography, microangiography, and histology was carried out. Histologic study focused on the tumor periphery and its relationship to the adjacent liver parenchyma. In particular, the type of tumor infiltration, the presence or absence of peritumoral fibrosis, and the degree of liver cell compression were assessed. In all but two cases the halo was extratumoral and was caused by peritumoral liver cell compression. In the remaining two cases the halo was tumoral and was caused by irregular fibrosis or vascularization.
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