PMC4818301_01
Abdominal dynamic computed tomographic (CT) image showing a 30-mm space-occupying lesion (arrowhead) in segment 5 of the liver, which was visible as a homogeneously enhanced lesion at an early phase (a), and was washed out at a late phase (b). CT during hepatic arteriography revealed a hypervascular tumor (c), and CT during arterial portography revealed a perfusion defect (d). No other tumors were found in the examination.
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The lesion presented with washout at a late phase (Fig. 1a, b). Further, CT during arterial portography (CTAP) revealed a perfusion defect in segment 5 (Fig. 1c, d).
Cut surface of the resected specimen showing a 10- x 10-mm yellow-brown nodular lesion (a). The histopathological finding showed fibrosis and numerous infiltrating lymphocytes and plasma cells in the tumor (b: hematoxylin and eosin stain, x400). Many infiltrating plasma cells were positive for IgG4 (c: on immunohistochemistry, x400).
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IPT of the liver (Fig. 2). Infiltrating plasma cells were positive for immunoglobulin G4 (IgG4) on immunohistochemistry.
Contrast-enhanced magnetic resonance image (MRI) showing two new lesions with perfusion defect at the hepatic cell phase and good enhancement at the arterial phase. The white arrowhead indicates the 16-mm tumor near the border of segment 8 (a: hepatic cell phase, a': arterial phase). The black arrowhead indicates the 10-mm tumor below the hepatic dome in segment 8 (b: hepatic cell phase, b': arterial phase). The follow-up MRI scan obtained 3 months later shows that the tumor near the border of segment 8 had grown to 20 mm (c: white arrow) and that the lesion below the hepatic dome had grown to 17 mm (d: black arrow).
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In a follow-up MRI that was performed 3 months later, the tumor near the border of segment 8 was observed to have grown from 16 to 20 mm, and the tumor below the hepatic dome was observed to have grown from 10 to 17 mm (Fig. 3).