case_images: PMC9679012_01
case_images: Preoperative enhanced magnetic resonance imaging (MRI) examination. (A) T1WI shows an ovalshaped hypointense lesion with clear border in the right lobe of the liver (arrows, 94x74 mm). (B) Fat-suppressed T2WI shows a slightly hyperintense lesions (arrows). (C,D) The in-phase (C) and out-of-phase (D) of T1WI demonstrates hypointense speckled signals within the mass (arrows). (E) DWI shows a hyperintense lesions (arrows). (F-J) Enhanced MRI scans showed progressive enhancement of the lesion (arrows) on the early (F) and late (G) arterial phase, portal venous phase (H), delayed phase (I), and coronal view (J), while no enhancement was seen in the necrotic region. MRI, magnetic resonance imaging; T1WI, T1 weighted image; T2WI, T2 weighted image; DWI, diffusion weighted imaging.
case_images: fmed-09-1002324-g001.jpg
case_images: PMC9679012_01_fmed-09-1002324-g001.jpg
case_images: F1
case_images: T1WI. Therefore, the primary diagnosis highly suggested a hepatic fat-poor angioleiomyolipoma (Figure 1).
case_images: Postoperative pathology examinations. (A) Grossly, the cut surface of the fleshy neoplasm with necrosis and hemorrhage (tumor size: 7.0x5.0 cm); (B) H&E stained image showing that the tumor tissue had a meshwork-like architecture with abundant vascular-like proliferation, magnification: 200X; (C) The positive IHC result of CD21, magnification: 100X; (D) The positive IHC result of CD35, magnification: 100X; (E) The positive result of EBV for in situ hybridization, magnification: 200X. H&E, hematoxylin and eosin; IHC, immunohistochemical; EBV, Epstein Barr virus.
case_images: fmed-09-1002324-g002.jpg
case_images: PMC9679012_01_fmed-09-1002324-g002.jpg
case_images: F2
case_images: According to the infiltration of numerous lymphocytes into the neoplastic tissues and immunohistochemical detection of CD21 and CD35 expression as well as in situ hybridization detection of Epstein-Barr virus-encoded RNA (EBER), the morphological and immunophenotypic results were consistent with a diagnosis of IPT-like FDCS (Figure 2).