PMC4411815_01
Hypodense lesion in segment 7 of the liver suggestive of metastasis (a). Hypodense lesion in segment 3 of the liver suggestive of metastasis (b)
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F1
Post-operative contrast enhanced computerized tomography of the abdomen showed multiple hypodense lesions in both lobes of the liver suggestive of metastases [Figure 1a and b].
Microphotograph showing numerous confluent epithelioid granulomas effacing the normal liver architecture (H and E, x100) (a). High power view of caseating granuloma with adjacent normal hepatocytes (H and E, x400) (b). adenocarcinomatous glands with extracellular mucin infiltrating the muscle layer (H and E, x100) (c). High power view showing glands lined by malignant cells having enlarged hyperchromatic nuclei, coarse chromatin and eosinophilic cytoplasm (H and E, x400)
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F2
Histopathological examination of the resected bowel revealed well-differentiated mucin secreting adenocarcinoma invading the muscular layer [Figure 2c and d]. Biopsy from the liver nodules showed multiple confluent epithelioid granulomas with caseation necrosis suggestive of TB [Figure 2a and b].