The image shows a 42-year-old female. Five years previously she had presented with a subacute bowel obstruction and a palpable mass in the right iliac fossa. She underwent a laparotomy, when a tumour was found in the terminal ileum, together with enlarged nodes in the adjacent mesentery. The liver was macroscopically entirely normal. The affected segment of bowel and the adjacent mesentery were resected and she made an excellent recovery.
She now has a considerable hepatomegaly, which extends 10 cm below the right costal margin. Together with this, she has a striking appearance of a flushed, reddish blue complexion, which gets even more intense after food or if she has a glass or two of wine.
What’s the diagnosis ?
