PMC3368299_01
(a) Coronal computed tomography imaging demonstrating cystic tumour within the liver with more peripheral solid component. (b) Intraoperative image of large, partially haemorrhagic hepatic tumour overlying the right colon.
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fig1
Computed tomography (CT) was performed and demonstrated an encapsulated solid and cystic tumour involving the right lobe of the liver, measuring 16 cm in maximum diameter (Figure 1(a)). At the time of surgery a large, a well-circumscribed, partially haemorrhagic cystic lesion was noted (Figure 1(b)).
(a) Microscopic view of densely cellular area comprised of pleomorphic round and spindled cells (hematoxylin and eosin, x200). (b) Paucicellular area with myxoid matrix (hematoxylin and eosin, x200).
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fig2
The tumour was comprised of densely cellular areas of rounded and pleomorphic cells and myxoid more paucicellular areas with stellate and spindled cells (Figure 2).
(a) Alpha1-antitrypsin immunohistochemistry diffusely staining tumour cells (x200). (b) Vimentin immunohistochemistry staining tumour cells (x200). (c) PAS-positive, diastase-resistant intratumoral cytoplasmic and extracellular eosinophilic globules (x200). (d) Malignant hepatoid tumour nodule within the tumour (hematoxylin and eosin, x200).
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fig3
Variably sized eosinophilic, intracytoplasmic, PAS-positive, diastase resistant globules were also noted within occasional tumour cells (Figure 3). In addition, nodules of malignant hepatoid tumour were admixed with the undifferentiated areas (Figure 3(d)) and stained positively for HepPar-1, polyclonal carcinomembryonic antigen, and AE1/AE3.