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Fig. 3D —32-year-old man with focal liver lesion in left lobe in unenhanced sonography group. First and second biopsy procedures were performed with 21-gauge manual aspiration needle guided by conventional sonography. Pathologic diagnosis of both biopsy samples was hepatocellular fatty degeneration. Photomicrograph of biopsy specimen shows tumor cells to exhibit glandular structures and form into multilayer in some areas. Pathologic diagnosis of biopsy sample was cholangiocarcinoma.