PMC5937564_01
A chest X-ray showing no mediastinal mass and normal lung parenchyma. Generalized osteopenia was identified at the vertebral area.
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Chest X-ray showed generalized osteopenia (Figure 1).
CT chest and whole abdomen (coronal view) showing marked hepatosplenomegaly, enlarged size of the pancreas, and numerous heterogeneous masses at both lobes of the liver and the pancreas.
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CT chest and whole abdomen (Figures 2 and 3) revealed hepatomegaly and numerous heterogeneous low-attenuation centers varying in size, with peripheral rim-enhancing masses scattered in both hepatic lobes, and the largest one was 8 x 7.5 x 11.6 cm in size.
CT chest and whole abdomen (axial view). (a) Multiple masses at both lobes of the liver, the spleen, and the pancreatic body and tail. (b) The largest hepatic mass of 8 x 7.5 x 11.6 cm in diameter.
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CT chest and whole abdomen (Figures 2 and 3) revealed hepatomegaly and numerous heterogeneous low-attenuation centers varying in size, with peripheral rim-enhancing masses scattered in both hepatic lobes, and the largest one was 8 x 7.5 x 11.6 cm in size.
Liver biopsy revealing proliferation of atypical tubular elements associated with fibrous stroma characteristic of cholangiocarcinoma. H&E staining, original magnification: (a) x10 and (b) x40.
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Histological examinations of fine-needle biopsy showed poorly differentiated tubular adenocarcinoma (Figure 4).
The bile canalicular immunohistochemical staining pattern in cholangiocarcinoma with diffuse positivity in cytoplasmic membrane staining of CK7 (a) and CK19 (b).
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Immunohistochemical staining showing lack of the monoclonal CEA (a) and the polyclonal CEA (b).
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