case_images: PMC11829831_01
case_images: Radiologic findings of a primary hepatic alpha-fetoprotein-producing neuroendocrine neoplasm. a Pre-contrast CT image reveals multiple tumorous lesions within the liver. b Contrast-enhanced arterial phase of the CT scan. Strong contrast enhancement is evident at the periphery of the occupying lesion, while the interior shows hypovascularity. In addition, the tumor periphery exposed to the liver surface exhibits a concave indentation. These findings are consistent with those of intrahepatic cholangiocarcinoma. CT computed tomography
case_images: 795_2024_408_Fig1_HTML.jpg
case_images: PMC11829831_01_795_2024_408_Fig1_HTML.jpg
case_images: Fig1
case_images: Subsequently, contrast-enhanced computed tomography (CT) revealed multiple lesions in the liver (Fig. 1a, b).
case_images: Histopathology of primary hepatic alpha-fetoprotein-producing neuroendocrine neoplasm. a Low-magnification images of the liver biopsy (scale bar = 500 mum). b High-power view of the selected area (blue square) in a. Histologic findings reveal atypical cells with abundant cytoplasm and enlarged nuclei forming cord-like structures or a nested organoid growth pattern (scale bar = 100 mum). Immunohistochemically, the tumor stained positive for c, d synaptophysin, e chromogranin A, f CK19, and g, h alpha-fetoprotein (c, g: scale bar = 500 mum, d, h: scale bar = 100 mum, e, f: scale bar = 50 mum). d High-power view of the selected area (blue square) in c. h High-power view of the selected area (blue square) in g. c Almost all neoplastic cells stained positive for synaptophysin. g About half of the neoplastic cells stained positive for alpha-fetoprotein
case_images: 795_2024_408_Fig2_HTML.jpg
case_images: PMC11829831_01_795_2024_408_Fig2_HTML.jpg
case_images: Fig2
case_images: Histopathological examination of the liver biopsy specimen showed proliferating atypical cells with abundant cytoplasm and enlarged nuclei, forming cord-like structures or a nested organoid growth pattern with surrounding fibrosis (Fig. 2a, b). Tumor necrosis or degeneration was not apparent (Fig. 2a). Immunohistochemical analysis revealed cells positive for neuroendocrine markers, including synaptophysin (Fig. 2c, d), chromogranin A (Fig. 2e), CK19 (Fig. 2f), and AFP (Fig. 2g, h). Most neoplastic cells were positive for synaptophysin (Fig. 2c, d), and about half of the neoplastic cells were positive for AFP (Fig. 2g).