PMC3891746_01
Non-FDG avid liver lesion on PET/CT.
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fig1
Patient worked as a nurse, and due to vague generalized symptoms she insisted on PET scan to be done which revealed a nonmetabolically active lesion in the liver, slightly less metabolically active than the surrounding liver parenchyma, with no other lesions being identified on PET scan as a primary site (Figure 1).
T1 hypointense liver lesion on MRI.
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fig2
A dedicated liver MRI revealed a hypervascular lesion with irregular lobulated margins in the anterior right lobe of the liver near the falciform ligament that was T1 hypotense (Figure 2) and T2 hypertense (Figure 3) with heterogeneous increased enhancement during arterial phase with a fairly rapid washout.
T2 hyperintense liver lesion on MRI.
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fig3
A dedicated liver MRI revealed a hypervascular lesion with irregular lobulated margins in the anterior right lobe of the liver near the falciform ligament that was T1 hypotense (Figure 2) and T2 hypertense (Figure 3) with heterogeneous increased enhancement during arterial phase with a fairly rapid washout.
Haphazard arrangement of epithelioid cells with cleared-out cytoplasm.
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fig4
On H&E staining a haphazard arrangement of epithelioid and spindle cells with cleared-out cytoplasm was seen (Figure 4).
Melan-A stain.
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fig5
The tumor on immunohistochemistry staining was strongly positive for Melan-A (Figure 5) and HMB-45 (Figure 6) and negative for S-100, Hepar-1, ER, PR, desmin, CK7, CK20, CD10, CD117, CD31, synaptophysin, and vimentin.
HMB-45 stain.
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fig6
The tumor on immunohistochemistry staining was strongly positive for Melan-A (Figure 5) and HMB-45 (Figure 6) and negative for S-100, Hepar-1, ER, PR, desmin, CK7, CK20, CD10, CD117, CD31, synaptophysin, and vimentin.