PMC4531615_01
Abdominal CT finding. (A) Arterial phase. It shows a 6x 5 cm mass with relatively discrete margin in the left medial segment of the liver. The left hepatic duct was encased by the mass and there was diffuse dilatation of intrahepatic bile ducts in the left lobe. (B) Arterial phase. It shows a small early enhanced mass in right posteroinferior segment.
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The mass was not enhanced in the arterial phase of abdominal CT and intrahepatic bile ducts of the left lobe were dilated to the peripheral portion from the mass (Figure 1). In abdominal CT, another 1.5 cm sized mass was found in the right posteroinferior segment of the liver, which was enhanced in the early arterial phase, but washed out in the early portal phase (Figure 1).
Hepatic angiography. It shows a large hypovascular mass in the left lobe (arrowhead) and some dot-like small nodular staining lesions around the left lobe. A small nodular hyper staining mass is noted in the right posteroinferior segment (arrow).
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In hepatic angiography, hypervascularity were demonstrated around the periphery of the tumor (Figure 2). However, intrahepatic metastasis from cholangiocarcinoma of the left lobe could not be excluded (Figure 2).
Gross and microscopic findings of the stomach lesion. (A) A 2x 1.5 cm sized and well-demarcated flat lesion is noted at the proximal antrum of the greater curvature on gastroscopic examination. (B) Moderate to well-differentiated neoplastic epithelial cells with glandular differentiation are noted on microscopic examination (HE stain, x 100).
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On gastroscopic examination, a 2x1.5 cm sized well-demarcated lesion was found at the greater curvature of the proximal antrum (Figure 3A). The well-differentiated adenocarcinoma of early gastric cancer type IIb was confirmed by pathologic examination (Figure 3B).
Microscopic finding of liver cancers. (A) Microscopic examination of the main mass revealed moderately-differentiated neoplastic epithelial cells with glandular differentiation which is compatible with cholangiocarcinoma (HE stain, x 100). (B) Microscopic examination of another small mass disclosed neoplastic hepatocytes with solid or trabecular pattern and occasional acinar differentiation which is compatible with hepatocellular carcinoma (HE stain, x 200).
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Pathologic examination revealed moderately differentiated cholangiocarcinoma with severe fibrosis and necrosis (Figure 4A). Microscopic examination showed a well-differentiated hepatocellular carcinoma with solid or trabecular pattern and occasional acinar differentiation (Figure 4B).