I have hyperechoic liver with nodule. i drank for 15 years. could it just be fat?

With liver nodules, the first step is to differentiate between cirrhotic and non-cirrhotic changes. There are many types of benign tumors that will have to be considered, focal fatty changes,hepatocellular carcinoma or liver cancer. However, if cancerous, there is a higher chance to be metastatic originating in another organ. Biopsy can clarify, many times not needed due to new imaging modalities.

Yes, it certainly could be caused by fatty liver. However, it is important to realize that chronic fatty liver, or steatosis, can be a cause of further liver disease and even cirrhosis. Especially if your liver tests are abnormal, it is important to get this checked out. You should see your primary doctor or a gastroenterologist for further advice. Good luck.