PMC9188365_01
Chest X ray, enhanced abdominal CT on the admission. (A) Chest X ray showing a mass shadow in the left upper lung field. (B) Enhanced abdominal CT showing periportal collar signs. (C) Enhanced abdominal CT showing a heterogeneous contrast effect on the liver in the early contrast phase.
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Chest X-ray showed a mass shadow in the left upper lung field (Figure 1A). Enhanced abdominal computed tomography (CT) showed periportal collar signs and a heterogeneous contrast effect on the liver in the early contrast phase (Figure 1B and C).
Results of liver biopsy. (A) Histopathology of the liver shows focal necrosis in the liver parenchyma and lymphocytic infiltration around the central vein. (B) Many CD3 positive lymphocytes and (C) CD8 positive lymphocytes are present. (D) Few CD20 positive lymphocytes were present.
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Immunohistopathological staining showed that the number of CD3 or CD8 positive lymphocytes was markedly higher than that of CD20 positive lymphocytes (Figure 2).
Clinical course of the patient. Decreases in AST and ALT were observed after the administration of steroids.
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The amount of steroids was gradually tapered to 30, 20, 10, 5, and 0 mg daily every 7-10 days without any recurrence of liver injury (Figure 3).