PMC10039415_01
Triple-phase computed tomography of the abdomen. Innumerable hypo-enhancing liver lesions in an enlarged liver are demonstrated. Ascites and body-wall anasarca are also observed.
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F1
Computed tomography (CT) of the abdomen and pelvis showed cardiomegaly, hepatomegaly, and multiple ill-defined low-density lesions of varying sizes throughout the liver parenchyma (shown in Fig. 1).
a Neoplasm with organoid appearance and ill-defined cords, composed of small cells with central nuclei and inconspicuous nucleoli (H&E, x20). b Immunohistochemistry shows positive labeling for synaptophysin in tumor cells (x20).
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F2
Biopsy was consistent with tubular adenoma (shown in Fig. 2a, b).
Parasternal short axis view at the level of the aortic valve. The red arrow shows the thickened and calcified tricuspid valve.
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F3
The tricuspid valve leaflets were significantly thickened and calcified to the point of immobility (shown in Fig. 3).
Apical four-chamber view of the heart. The image shows severely dilated right atrium and ventricle, resulting in mal-coaptation of tricuspid valve leaflets (red arrows) and severe tricuspid regurgitation.
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F4
There was mal-coaptation of valve leaflets, resulting in severe regurgitation supported by hepatic vein systolic flow reversal (shown in Fig. 4).