PMC8716544_01
(A) Liver ultrasound. (B) Computed tomography (CT) plain scan. (C) The arterial phase of enhanced CT scans. (D) The portal phase of enhanced CT scans.
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F1
Ultrasound examination of the abdomen showed cystic liver lesions, ~38 x 28 and 13 x 8 mm in sizes, and separated light bands could be seen in the larger ones (Figure 1A). CT of the abdomen revealed multiple cysts in the liver; the larger ones were in the shape of a rosette and located in the lower part of the right lobe of the liver; the largest cross-sectional area was ~37 x 31 mm, and there seemed to be a separate structure inside (Figure 1B). In the arterial phase, the subcapsular enhancement focus of the lower right anterior lobe of the liver was enhanced (Figure 1C), which is unclear in the portal phase (Figure 1D) and cavernous hemangioma was considered.
(A) Colonic liver flexure polyps seen by endoscopy. (B) Gross specimen of colonic liver flexure polyps. (C) Microscopic image of colonic liver flexure polyps.
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F2
Under electronic colonoscopy, three flat polyps sized 2-4 mm were found in the liver flexure of the colon (Figure 2A), all of which were clamped. Macroscopically, the pathological tissue was four pieces of gray-white tissue with a size of 0.5 x 0.4 x 0.3 cm (Figure 2B), of which the pathological diagnosis was adenomatous polyps (Figure 2C).
(A) Gross specimen of the right liver tumor. (B) Microscopic image of the right liver tumor. (C) Immunohistochemical staining of the cyst gland duct epithelium (CK+). (D) Immunohistochemical vascular staining (CD34+).
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F3
The cut surface was gray-red, and the surgical specimen was solid and soft, with no obvious nodules (Figure 3A). The microscope showed that the structure of the liver lobules was basically normal, the liver cells were focally degenerated, focal hyperplastic ducts were observed, and most of the cystic structures were not clearly lined with the epithelium (Figure 3B). Combined with the results of immunohistochemistry (CK+, CD34+), it is consistent with biliary cystadenoma (Figures 3C,D).
(A) Computed tomography (CT) plain scan after surgery. (B) The arterial phase of enhanced CT scan 2 months after surgery. (C) The portal phase of enhanced CT scan at postoperative 2 months.
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F4
Postoperative CT showed resection of the posterior lower segment of the right liver lobe; a small amount of fluid, blood, and gas in the residual cavity; drainage tube indwelling; and a small amount of fluid around the gallbladder fossa (Figure 4A). Re-examination at postoperative 2 months revealed changes in CT findings after resection of the posterior lower segment of the right liver lobe and cystic fluid in the residual cavity, and a small amount of fluid around the original gallbladder fossa was absorbed and dissipated (Figures 4B,C).