PMC3909862_01
Case 1. Fibropolycystic liver disease mimicking hepatic mass in 44-year-old woman.. A. Transverse abdominal ultrasound shows ill-defined isoechoic solid mass with multiple internal cystic components in lateral segment of liver. B. Axial contrast-enhanced abdominal CT scan shows ill-defined cystic mass with marginal tubular components. C. Gross findings of hepatic left lobe shows aggregates of numerous small and large biliary cysts. D. Microscopic findings of mass-like monosegmental fibropolycystic disease shows numerous dilated intrahepatic bile ducts, with irregular contours, infoldings, and protrusions, surrounded by thick fibrous tissue, which were features of ductal plate malformation (hematoxylin-eosin stain, x 200). E-G. Immunohistochemical stains for CD10 (E), CK7 (F), and MUC1 (G) show positive in lining (epithelial cells) of dilated cysts, as well as those of proliferative bile ductules (x 200).
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F1
On the present admission, ultrasound showed an ill-defined, isoechoic mass, with internal cystic components in the lateral segment of the liver (Fig. 1A). A three-phase abdominal CT scan showed an irregularly-marginated multicystic mass with tubular components, and with no contrast enhancement (Fig. 1B). The cut surface of the hepatic left lobe showed aggregates of numerous small and large biliary cysts (Fig. 1C). There were ductal plate malformations of numerous dilated biliary cysts (Fig. 1D). Immunohistochemical stains for CD10 (Fig. 1E), CK7 (Fig. 1F), and MUC1 (Fig. 1G) showed positive reactions in the lining (epithelial cells) of dilated cysts, as well as proliferative bile ductules.
PMC3909862_02
Case 2. Fibropolycystic liver disease mimicking hepatic mass in 46-year-old man.. A. Axial contrast-enhanced abdominal CT image shows ill-defined mass composed of numerous cysts and tubular lesions in segment VI of liver. B, C. Axial T2- and T1-weighted abdominal MR images show ill-defined mass composed of numerous cysts and tubular lesions. D. Axial contrast-enhanced abdominal MR image shows tubular and cystic lesions with no contrast enhancement. E. Microscopic finding of needle biopsy specimen shows several, irregular-shaped, dilated intrahepatic bile ducts, lined by cuboidal biliary epithelial cells. There is also ductal plate malformation and numerous inflammatory cells in background of fibrous tissue (hematoxylin-eosin stain, x 200). F-H. Immunohistochemical stains for CD10 (F), CK7 (G), MUC1 (H) shows positive in lining (epithelial cells) of dilated cysts (x 200).
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F2
A three-phase abdominal CT scan showed an ill-defined mass composed of numerous cysts and tubular lesions in segment VI of the liver (Fig. 2A). Magnetic resonance (MR) images showed a cystic mass with very high T2 and low T1 signal intensities (Fig. 2B, C). Post-contrast MR images showed no contrast enhancement of this mass (Fig. 2D). Microscopic findings of the needle biopsy specimen showed several, irregular-shaped, dilated intrahepatic bile ducts, lined by the cuboidal biliary epithelial cells (Fig. 2E). Immunohistochemical stains for CD10 (Fig. 2F), CK7 (Fig. 2G), and MUC1 (Fig. 2H) showed positive reactions in the lining (epithelial cells) of dilated cysts, as well as proliferative bile ductules.
PMC3909862_03
Case 3. Fibropolycystic liver disease mimicking hepatic mass in 50-year-old man.. A. Transverse abdominal ultrasound shows ill-defined hyperechoic solid mass with multiple internal cystic components in segment VIII of liver. B. Axial contrast-enhanced abdominal CT scan shows ill-defined cystic mass with marginal tubular components. C, D. Axial T2- and contrast-enhanced T1-weighted abdominal MR images show ill-defined mass composed of numerous cysts and tubular lesions. E. Three dimensional magnetic resonance cholangiopancreatography shows aggregates of cystic and tubular lesions.
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F3
Ultrasound showed an ill-defined echogenic mass with multiple varying-sized cystic components in the right lobe of the liver (Fig. 3A). A three-phase abdominal CT scan showed an irregularly-marginated mass with tubular components but with no contrast enhancement (Fig. 3B). MR imaging showed a cystic mass with very high T2 signal intensities (Fig. 3C). Post-contrast MR image showed a cystic mass with no contrast enhancement (Fig. 3D). 3 dimensional magnetic resonance cholangiopancreatography (MRCP) showed a cystic mass with tubular and cystic components (Fig. 3E).