Discrete coarsened increased echogenicity of the liver with history of hemochromatosis meaning on ultrasound?

This is . A nonspecific finding on ultrasound though hemochromatosis in one of the many things that can cause this appearance. Magnetic resonance imaging (MRI) is the best imaging examination to evaluate abnormal iron deposition in the liver.
See answer. The concern is that this may represent developing cirrhosis. Ultrasound generally does not delineate iron deposition per se. A more definitive imaging modality for hemachromatosis imaging is MRI which can better evaluate the degree of iron deposition that is occurring. It would be important to also evaluate the pancreas.