PMC9812437_01
PET-CT exposed abnormal FDG uptake in the rectum (A), liver and spleen (B, C), bone (A, D, E), left parotid gland (E) and multiple enlarged lymph nodes.
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Positron emission tomography-computed tomography (PET-CT) exposed multiple abnormal fluorodeoxyglucose (FDG) uptake in rectum (standardised uptake value (SUV)max 6.7), liver (SUVmax 6.4), spleen (SUVmax 5.5), bone (SUVmax 12.0), left parotid gland (SUV max 21.2) and multiple enlarged lymph nodes in the bilateral cervical and periclavicular, right hilar, mediastinal, retroperitoneal, para-aortic, bilateral internal and external iliac regions (SUVmax 20.7) ( Figuress1A, E ).
Histopathological examination of biopsies from both the retroperitoneal enlarged lymph nodes and liver lesions revealed diffuse large B- cell lymphoma (A). Bone marrow biopsy of L4 vertebrae was positive for lymphoma (B).
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Hepatic S6 nodule were performed. Histopathological examination of biopsies from both the retroperitoneal enlarged lymph nodes and liver lesions revealed DLBCL ( Figure 2A ), with CD20(+), CD30(30%+), Bcl-2(+), Bcl-6(+), MUM-1(+), c-Myc(30-60%+), P53(40%+). Bone marrow biopsy of L4 vertebrae was positive for lymphoma ( Figure 2B ).
The colonoscopic biopsy suggested moderately differentiated adenocarcinoma.
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The colonoscopy showed a hard-intraluminal ulcerated mass in the rectum, approximately 8cm from the anal verge, and the biopsy of the lesion suggested moderately differentiated adenocarcinoma ( Figure 3 ).
After six cycles of R-Gemox chemotherapy, follow-up abdominal enhancement CT exposed that the hepatic S8 lesion has a rapid progression measuring longest diameter 51mm with arterial phase enhancement (A) with portal venous phase washout (B).
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However, follow-up abdominal enhancement CT exposed that the hepatic S8 lesion showed in previous CT scan has a rapid progression measuring longest diameter 51mm with imaging characteristics of "quick wash-in and wash-out" ( Figures 4A, B ), which strongly suggested HCC.
Pathological examination of liver needle biopsy confirmed that the S8 lesion was hepatocellular carcinoma.
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Liver needle biopsy confirmed that the S8 lesion was HCC ( Figure 5 ).