PMC5099262_01
(A) Plain scan showed the lesion was low density with a lower density scar showed in the center. (B) In the arterial phase, the lesion was significantly enhanced without central scar tissues and showed a clear capsule. (C) The lesion was decreased in the venous phase.
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On arterial and portal venous phase imaging, the tumor continued to exhibit a brightly enhanced early phase and early washout (Fig. 1).
Gross pathology of the resected tumor shows an 11-cm tumor with a round-like appearance, compatible with the imaging features.
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On the gross pathologic examination of the surgical specimen, the tumor was shown to be enlarged in the right posterior liver, well-defined, yellow-to-tan in color, and 11 x 8 x 7 cm in size, with numerous small nodes on the surface of the liver tumor (Fig. 2).
(A-B) Well-defined, non-encapsulated tumor, composed of nodular hepatocytes with "cirrhosis-like" architecture, separated by fibrous septa. Numerous duct-like structure proliferations with scattered lymphocytes (hematoxylin & eosin, 40X). (C) Architectural disturbance caused by fibrous septa linking portal tracts (Masson staining, 100X). (D) Immunostaining for CK7 shows ductular reaction and phenotypic switching of the hepatocytic cytokeratins, reflecting long-standing intrahepatic cholestasis (CK7 immunostaining, 100X). (E) Immunostaining for CD34 shows a large sum of vascular endothelial cells which proliferated widely (CD34 immunostaining, 100X). (F) Immunostaining for Ki-67 shows the lower expression of proliferation (<1%, Ki-67 immunostaining, 100X).
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The pathologic findings were consistent with FNH (Fig. 3).