case_images: PMC10185437_01
case_images: CT and gross. (A) Abdomen (axial view) showing enlarged liver with a well-circumscribed hypoattenuating cystic lesion involving the right lobe; (B) CT abdomen (sagittal view) showing a homogenous nodular enhancement noted along the anterior wall of the cyst; (C) right lobe of the liver with attached cyst with the smooth, intact, and congested external surface; (D) cut surface of the cyst was predominantly cystic, uninoculated, irregular, and haemorrhagic with attached yellowish, friable material. The wall showed focal nodular thickening. The patient underwent partial hepatectomy with cholecystectomy followed by histopathological examination (HPE) of the same
case_images: etat-04-1002133-g001.jpg
case_images: PMC10185437_01_etat-04-1002133-g001.jpg
case_images: F1
case_images: A homogenous nodular enhancement was noted along the anterior wall of the cyst measuring 3.9 cm x 1.5 cm in size (Figure 1A and B). A solid grey area was noted within the cyst which measured 3.0 cm in greatest dimension (Figure 1C and D).
case_images: Histopathological findings. (A) Section from cyst wall shows tumour cells arranged in a glandular pattern [hematoxylin and eosin (HE), 100x]; (B) papillary pattern of tumour cells (HE, 100x); (C) salt and pepper chromatin of the tumour cells (HE, 400x, inset-mitoses); (D) satellite nodule of tumour surrounded by normal hepatic sinusoids (HE, 40x, inset-lymphovascular emboli)
case_images: etat-04-1002133-g002.jpg
case_images: PMC10185437_01_etat-04-1002133-g002.jpg
case_images: F2
case_images: Sections from the adjacent liver showed multiple satellite nodules tumours with similar histomorphology (Figure 2).
case_images: Immunohistochemical stains. (A) Tumour cells showing diffuse and strong cytoplasmic positivity for synaptophysin (IHC, 400x); (B) tumour cells showing positivity for Cg (IHC, 400x); (C) Ki-67 index: 10-12% (IHC, 400x)
case_images: etat-04-1002133-g003.jpg
case_images: PMC10185437_01_etat-04-1002133-g003.jpg
case_images: F3
case_images: Immunohistochemistry (IHC) workup revealed diffuse and strong positivity for synaptophysin and chromogranin (Cg), and the Ki-67 proliferation index (Ki-67 index) was 10-12% (Figure 3).