PMC2822180_01
MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)
CJ-06-25-g001.jpg
PMC2822180_01_CJ-06-25-g001.jpg
F0001
The mass lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images [Figure 1].
Photomicrographs from aspiration smears from hepatic mass demonstrating singly lying polygonal cells (a, Papanicolaou x 100). A cellular fragment with one cell showing an intranuclear inclusion (arrow) is seen (b, Papanicolaou x 100). The polygonal cells display moderate nuclear pleomorphism (c, May-Grunwald-Giemsa stain x 200). Higher-power view shows an intranuclear inclusion marked by arrow (d, May-Grunwald-Giemsa stain x400)
CJ-06-25-g002.jpg
PMC2822180_01_CJ-06-25-g002.jpg
F0002
The aspiration smears were paucicellular and showed single cells and occasional small tissue fragments [Figure 2a-c]. In addition, scattered larger malignant-appearing pleomorphic cells with moderate amount of cytoplasm and hyperchromatic nucleus were noted [Figure 2a]. Sharply-defined intranuclear pseudoinclusions were noted in many cells [Figure 2b, d].
Histological photomicrographs demonstrating singly-lying and cords of cells embedded in a desmoplastic stroma (a, H and E x100). The tumor cells show intracytoplasmic lumina containing red blood cells (b, H and E x200). Immunostaining reveals cytoplasmic positivity for CD31 in the tumor cells (c, x100) and focal positivity for pancytokeratin (d, x200).
CJ-06-25-g003.jpg
PMC2822180_01_CJ-06-25-g003.jpg
F0003
Biopsy section showed a small fragment of liver parenchyma along with fibrous tissue infiltrated by scattered tumor cells [Figure 3a]. Prominent intracytoplasmic vacuoles were seen in many tumor cells [Figure 3b]. Immunohistochemistry revealed the tumor cells to be strongly and diffusely positive for CD31 [Figure 3c] and CD34 with focal reactivity for pancytokeratin [Figure 3d].