1 Fatty infiltration, fibrosis, and vascular abnormalities can all present similarly.1 RILD presents as demarcated areas of hypo- or hyperattenuation in a nonanatomic distribution, contrasting with vascular lesions.1Our patient developed RILD following hepatic radiation exposure during irradiation of right chest wall/axilla 6 weeks earlier. Subsequent tests after 4 months and later imaging showed complete normalization of liver enzymes and hepatic appearance (Fig 1B). As of May 2008, our patient was free of recurrent disease.