PMC10328728_01
MRI showing nodular lesion arising from right hepatic lobe, in dynamic evaluation, after Gd-EOB-DTPA administration, heterogeneously captures the contrast product in a mainly peripheral way, and maintaining areas of central hyposignal.
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fig1
An MRI with administration of paramagnetic hepatospecific contrast product, showed an exophytic nodular lesion with 56 mm x 83 mm heterogeneous signal in the different weightings, heterogeneously capturing the contrast product in a mainly peripheral way, maintaining areas of central hyposignal probably with a more fibrosis/hyalinization component (Figure 1), in an otherwise normal liver.
Surgical resection specimen with 8.4 cm x 7.9 cm x 5.0 cm and 192 g.
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The surgical specimen revealed a well-defined tumor with 7.9 cm in largest dimension (Figure 2).
Longitudinal cut:tumor with 7.9 cm x 6.3 cm x 4.7 cm is 1.5 cm from the surgical margin.
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The tumor was confined to the liver parenchyma without invasion of the hepatic capsule (Figures 3 and 4).
(a) The tumor is well defined with different layers and a fibronecrotic core. (b) Lower magnification of the histological features of the tumor with different layers and in the periphery non-tumor liver (H&E 40x).
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The tumor was confined to the liver parenchyma without invasion of the hepatic capsule (Figures 3 and 4).
Peripheral area:H&E 100x.
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Histological examination showed a hepatocellular tumor with a peripheral area with a predominant trabecular pattern with steatosis, cholestasis, and fibrovascular septa with a lymphocytic inflammatory infiltrate (Figure 5).
Central area:H&E 200x.
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In the central area, there were foci of atypical cells and necrosis (Figure 6).
(a) Loss of reticulin fibers in the inner layer of the tumor (reticulin stain:40x). (b) Immunohistochemical study: tumoral cells with cytoplasmic expression of beta-catenin with no nuclear expression of beta-catenin (beta-catenin 100x). (c) Expression of GS (GS 40x). (d) Diffuse expression of CRP (GS 40x).
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fig7
The beta-catenin expression was membranous only (Figure 7). The tumoral cells had no expression of glypican-3 (GPC-3) and heat-shock protein 70 (HSP-70) (Table 1).