PMC4899859_01
51-year-old female with primary intrahepatic gastrinoma. Delayed, contrast-enhanced axial CT shows a subtle mass (red asterisk) in the caudate lobe that is isodense to the liver parenchyma with possible faint rim enhancement.
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In retrospect, this lesion is more clearly seen on MRI and can be faintly seen on CT (Fig. 1).
51-year-old female with primary intrahepatic gastrinoma. T1 images, before (A) and after (B) gadolinium enhancement, show an oval, solid lesion within the caudate lobe of the liver measuring 3.4 x 3.0 cm (red asterisk). The lesion is most conspicuous on arterial dominant-phase-enhanced images, where it demonstrates a hypervascular appearance.
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On the MRI, the mass is most conspicuous in the arterial phase, where it demonstrates a hypervascular appearance (Figs. 2A and 2B).
51-year-old female with primary intrahepatic gastrinoma. Focal area of intense uptake in the upper abdomen almost in the midline (red arrow) corresponds to the solid lesion seen on the MRI. No other areas of increased uptake are seen.
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The Octreoscan showed a focal area of intense uptake in the upper abdomen, almost in the midline, corresponding to the solid lesion seen on the MRI. (Fig. 3).
51-year-old female with primary intrahepatic gastrinoma. A. Low-magnification view (4X) of the resected caudate lobe lesion demonstrates a pseudoglandular pattern of growth, one of the typical patterns for neuroendocrine tumors. B. High-magnification (40X) view of the lesion shows that the cell population is uniform, with finely granular, eosinophilic cytoplasm containing a low nuclear-to-cytoplasmic ratio. The nuclei are oval, with a dispersed chromatin ("salt and pepper") pattern.
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The resection margins were negative for tumor (see pathology images in Figs. 4A and 4B).