PMC9500349_01
MRI findings of this case (A) heterogeneous hyperintensity on T2 lipid-pressing sequence is shown. (B) Low signal on T1 lipid-pressing sequence is shown. (C) The arterial phase is markedly enhanced. (D) Hypointensities in the portal phase are shown.
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F1
The lesion in the right anterior segment of the liver was suggestive of hepatocellular carcinoma (Figure 1).
Contrast-enhanced liver ultrasound findings of this case contrast-enhanced ultrasonography of the nodules in the upper segment of the right anterior lobe of the liver showing washout performance (surrounded by crosses).
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F2
This showed arterial hypervascularity with washout, with a range of approximately 13 x 13 mm, suggesting a high possibility of primary hepatic carcinoma (Figure 2).
Histological findings of this case (A-D) hematoxylin and eosin staining of the tumor under multiple magnifications (A, x50) (B, x100). (C, x200) (D, x400). Microscopically, the tumor boundary is unclear and grows into the surrounding liver tissue. Epithelioid-like tumor cells can be seen arranged in a nest-like shape. Vascular components are visible, but adipocytes and smooth muscle components are not found. Under a high microscope objective, the tumor nuclei are round or oval with obvious nucleoli and atypia. (E) Tumor cells stained positive for HMB 45. Magnification at x200. (F) Tumor cells stained positive for SMA. Magnification at x200.
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F3
The nodule boundaries were unclear as they grew into the surrounding liver tissue (Figures 3A-D). The tumor cells were positive for estrogen receptor (1 + 40%), progesterone receptor (2 + 10%), desmin (focal + ), E-cadherin, vimentin, and human melanoma black (HMB) 45, smooth muscle actin (SMA) (Figures 3E, F).