PMC3760271_01
Computer tomography scan with contrast medium showing the liver mass with in the Segment VII of the right lobe with peripheral rim enhancement with central hypodensity.
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Abdominal computed tomography (CT) of the chest and abdomen showed a hypodense rim enhancing lesion about 3.5 cm by 2.5 cm in size with a necrotic center within segment VII (Figure 1) and another 2.8 cm by 2.1 cm lesion in segment IVB of the liver.
CT chest showing the pulmonary nodules.
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CT chest also revealed bilateral pulmonary nodules (Figure 2).
Histopathology of the hepatic mass. (a) Spindle shaped cells distributed in a collagenous stroma. (b) Spindle cells proliferation in interlacing pattern.
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A CT guided biopsy of the liver lesion in segment VII revealed a tumor comprising spindle cells arranged in interlacing pattern (Figures 3(a) and 3(b)).
Immunohistochemical staining of the hepatic tumor. (a) Cytoplasm of the spindle shaped tumor cells stain positive for smooth muscle actin. (b) Neoplastic cells stain positive with nuclear in situ hybridization for EBV.
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Immunohistochemical stains were positive for smooth muscle actin (Figure 4(a)) but negative for desmin, CD117, and CD34. In situ hybridization for Epstein-Barr virus (EBV) encoded small nuclear RNAs (EBER) (Figure 4(b)).