PMC3891419_01
(A) Computed tomography (CT) of liver demonstrates liver cirrhosis with splenomegaly. No definite mass in liver is seen. No other clinically significant abnormality is noted (Case 1). (B) Post-lipiodol CT scan of the liver shows neither lipiodol staining remaining in the liver parenchyme nor any interval change of liver cirrhosis (Case 1).
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F1
Computed tomography (CT) of the liver taken during the admission showed no definite mass or intrahepatic focal lesion in the liver (Figure 1A). The post-lipiodol hepatic CT scan taken 2 weeks after the angiography for detecting any hidden tumor also showed no focal lesion or remnant of lipiodol staining in the liver (Figure 1B).
Hepatic angiography of the liver shows no definite tumor staining in the liver parenchyme. Lipiodol test injection was performed (Case 1).
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F2
Hepatic angiography was carried out for the markedly elevated AFP level to rule out any possibility of hepatocellular carcinoma, but no definite tumor staining was noted in liver parenchyme (Figure 2).
Liver biopsy reveals severe porto-periportal inflammatory activity (4/4), mild lobular activity (2/4) and septal fibrosis (3/4). No evidence of malignancy is found (Left: H&E x 100, Right : V-blue x 100).
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F3
The sequentially performed liver biopsy showed severe porto-periportal inflammatory activity, mild lobular inflammatory activity and septal fibrosis, and these findings were compatible with chronic active hepatitis in liver cirrhosis (Figure 3).
PMC3891419_02
(A) Computed tomography (CT) of liver shows liver cirrhosis with splenomegaly. Presence of ascites and portal hypertension is noted with edema of the small bowel wall. No mass or focal lesion in the liver is seen (Case 2). (B) Post-lipiodol CT scan of the liver demonstrates neither lipiodol staining remaining in the liver parenchyme nor any interval change of liver cirrhosis and splenomegaly (Case 2).
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F4
A quantitative measurement of HbeAg was not carried out, and the other serologic findings were normal. A liver CT scan carried out during the admission confirmed liver cirrhosis with splenomegaly, ascites and portal hypertension, but there was no mass or focal lesion found in the liver (Figure 4A). A post-lipiodol hepatic CT scan was subsequently undertaken 2 weeks after the angiography for detecting any hidden tumor, and it showed neither focal lesion nor lipiodol staining in the liver (Figure 4B).
Hepatic angiography of the liver shows no definite tumor staining in the liver parenchyme. Lipiodol test injection was performed (Case 2).
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F5
There was no definite tumor staining on both lobes of the liver on the hepatic angiography (Figure 5).