PMC10213443_01
Abdominal computed tomography showing an elliptical low-density mass (white arrow) in the left inner lobe of the liver.
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F1
Abdominal CT revealed an elliptic low-density shadow (Figure 1) occupying the left inner lobe of the liver.
Magnetic resonance imaging of the liver showing a high-signal-intensity mass in both T1-weighted image (A, black arrow) and T2-weighted image (B, white arrow). Significant enhancement (C, black arrow) was noted in the enhanced arterial phase, revealing a mass of 4.7 x 4.2 cm in size.
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F2
T1 and T2 sequences. The mass measured 4.7 x 4.2 cm (Figure 2), after intravenous injection of contrast agent, and the lesion was significantly strengthened in the arterial stage and decreased in the portal and delayed stages, which was similar to the liver parenchyma enhancement.
Microscopic findings of the liver confirming B-cell non-Hodgkin's lymphoma of MALT type. (A, B, C, D, E, and F). (A) Medium-sized lymphoid cells infiltrated into the liver epithelium, forming lymphoepithelial lesions (hematoxylin-eosin staining). (B) Positive for the B-cell marker CD20. (C) Positive for the B-cell marker CD79alpha. (D) Negative for CD5.. (E). CD21 showed irregular follicular dendritic cell networks. (F) A relatively low proliferation fraction detected by Ki67 immunostaining (~13%).
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Unexpectedly, a hepatic lymphoma was diagnosed by postoperative histopathological examination, which showed medium-sized lymphocyte infiltration in the hepatic sinuses (Figure 3A). Immunohistochemistry was positive for the pan-B-cell marker CD20 and for CD79alpha, CD43, and Bcl-2; conversely, it was negative for CD3, CD5, cyclinD1 (Figures 3B-D). Moreover, CD21 shows irregular follicular dendritic cell networks (Figure 3E). The lymphoid cells showed a relatively low proliferation fraction as detected by Ki67 immunostaining (Ki-67 proliferation index: ~13%, Figure 3F).
The recent systemic CT scan revealed no recurrence.
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Fortunately, she was disease-free 18 months after the operation and the recent systemic CT scan revealed no recurrence (Figure 4).