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Presentation A 50 year old woman, who is a known case of multiple myeloma, post stem cell transplant and with GVHD [graft versus host disease] of the gut, skin and liver, underwent a tru-cut needle biopsy of the liver. This patient had elevated bilirubin and alkaline phosphatase. This is a hepatic ultrasound performed a week after the procedure. The patient was asymptomatic.
 
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