PMC10408630_01
(a) Coronal noncontrast computed tomography (CT) radiograph. (b) Sagittal noncontrast CT radiograph. (c) Axial noncontrast CT radiograph. Scans show heterogeneously enhancing mass centered in the high left parietal bone that measured approximately 5.0 x 4.5 x 4.6 cm with intracranial extension. There is mass effect upon the high left posterior frontoparietal brain where there may have been a trace amount of vasogenic edema. No abnormal parenchymal brain enhancement is noted. No acute intracranial hemorrhage or extra-axial fluid collections were identified. No areas that are strongly suspicious for acute cortical infarction or contusion were seen.
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F1
A computed tomography (CT) scan showed a heterogeneously enhancing mass centered in the high left parietal bone that measured approximately 5.0 x 4.5 x 4.6 cm with intracranial extension, but inconclusive on whether the mass was dural, osseous, or metastatic in origin [Figure 1].
(a) Contrast-enhanced, fat-saturated axial T1 image before treatment. The black arrow points to a rim-enhancing lesion centered in the right hepatic lobe. (b) Contrast-enhanced, fat-saturated axial T1 image after treatment. The black arrow points to the treated lesion in the right hepatic lobe.
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F2
CT of chest/abdomen/pelvis showing expected treated hepatic lesions and no new lesions [Figure 2]. Complete blood count, chemistry, coagulation panel, and liver function tests were within normal limits.
(a) (H&E stain, x15) Medium power view showing epithelioid tumor cells in cords and trabeculae separated by sinusoids. The underlying tissue has been completely replaced. (b) (H&E stain, x15) Medium power view showing thickened cords and nests (>2-3 cells thick) of tumor cells and central dilated blood vessel.
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F3
The tumor cells stained positive for cytokeratin AE1, AE3, hepar, and arginase-1 [Figures 3-5].
(H&E stain, x25) High power view showing tumor cells with prominent nucleoli, abundant eosinophilic cytoplasm and well-defined cell borders. Please also note small spindled endothelial cells surrounding the cell nests in so-called endothelial wrapping. Occasional cytoplasmic pigmentation was also identified.
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F4
The tumor cells stained positive for cytokeratin AE1, AE3, hepar, and arginase-1 [Figures 3-5].
(a) (Hepatocyte immunostain, x25) High power view of Hepatocyte immunostain showing strong and diffuse cytoplasmic granular staining. (b) (Arginase immunostain, x25) High power view of Arginase immunostain showing strong focal cytoplasmic staining.
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F5
The tumor cells stained positive for cytokeratin AE1, AE3, hepar, and arginase-1 [Figures 3-5].