Primary hepatic amyloidosis presenting as nodular masses on the background of diffuse infiltration and extreme liver stiffness on MR elastography.

Amyloidosis is characterized by the deposition of extracellular protein material, amyloid, in various organs. The clinical and imaging features of the disease are often nonspecific and a tissue biopsy is often required. We present the case of a 64-year-old man with biopsy proven amyloidosis of the liver. The patient presented with non-specific clinical symptoms. Routine imaging showed hepatomegaly with heterogeneous enhancement, and several large nodular space occupying lesions, mimicking neoplasm. MR elastography revealed an extremely stiff liver. Amyloidosis presenting as multiple nodular masses on the background of diffuse infiltrative pattern or demonstration of extreme stiffness in hepatic amyloidosis on MR elastography have not been described previously.

Naturally acquired human Plasmodium knowlesi infection, Singapore.

We report a case of naturally acquired Plasmodium knowlesi in Singapore, a malaria-free country. Diagnosis was confirmed by PCR with validated species-specific primers. In industrialized countries, free-ranging primates are a potential source of P. knowlesi human infection. P. knowlesi infection is a differential diagnosis of febrile illness acquired in Singapore.