PMC10155027_01
Multiphasic MRI showing hepatic mass (letter A).. Abbreviation: MRI, magnetic resonance imaging.
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Further imaging was pursued with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the abdomen that confirmed a large heterogeneous mass in the lateral-segment left lobe of the liver measuring 12 x 6.5 cm, an extensive portal vein thrombosis, portal, and peripancreatic lymphadenopathy which were concerning for malignant cause (Figures 1 and 2).
Multiphasic MRI showing portal vein thrombosis (letter c) and heterogenous
hepatic mass (blue arrow).. Abbreviation: MRI, magnetic resonance imaging.
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Further imaging was pursued with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the abdomen that confirmed a large heterogeneous mass in the lateral-segment left lobe of the liver measuring 12 x 6.5 cm, an extensive portal vein thrombosis, portal, and peripancreatic lymphadenopathy which were concerning for malignant cause (Figures 1 and 2).
(A) (B) Cytology smear with Diff-Quik stain showing nests of malignant cells
with increased nuclear-cytoplasmic ratio and marked nuclear
pleomorphism.
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A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).
(A) Routine hematoxylin and eosin staining of FFPE biopsies at increasing
magnification displaying malignant cells diffusely distributed throughout
the sample. (B) High-power view of malignant cells infiltrating the stroma
with strong nuclear staining and mitotic figures within pleomorphic
nuclei.. Abbreviation: FFPE, formalin-fixed-paraffin-embedded.
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A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).
Immunohistochemical staining of tissue biopsy: (A) Broad positivity (brown)
for hepatocyte stain of the malignant cells. (B) Strong focal positivity
(brown) of the malignant cells for cytokeratin-7. (C) Negative staining for
glypican throughout the tissue sample.
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A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).