case_images: PMC10948173_01
case_images: a Transverse CT image of the abdomen taken 6 months prior to presentation. b Transverse CT image of the abdomen demonstrating multiple lesions throughout the grossly enlarged liver indicated by black arrows and hypoattenuation indicating thrombosis within the portal vein showcased by white arrow.
case_images: crg-2024-0018-0001-536619_F01.jpg
case_images: PMC10948173_01_crg-2024-0018-0001-536619_F01.jpg
case_images: F1
case_images: An initial computed tomography (CT) scan of the abdomen and pelvis with contrast showed multiple masses throughout the liver and an associated partial splenic vein and portal vein thrombosis (PVT) (shown in Fig. 1). A CT scan from 6 months prior showed no liver pathology (shown in Fig. 1).
case_images: a MRI of the abdomen, showing numerous lesions throughout the grossly enlarged liver by white arrowheads. b White arrows point to an area of increased attenuation within the portal vein indicative of thrombus.
case_images: crg-2024-0018-0001-536619_F02.jpg
case_images: PMC10948173_01_crg-2024-0018-0001-536619_F02.jpg
case_images: F2
case_images: Magnetic resonance imaging of the abdomen with and without contrast did not disclose any biliary obstruction, however revealed evidence of hepatomegaly with the craniocaudal liver span in the mid clavicular line measuring up to 26 cm and several multiseptated cystic hepatic masses with an associated PVT (shown in Fig. 2).
case_images: Low (x40) H&E image of abscess material with granulation tissue (a) and high magnification (x200) H&E image of adjacent liver parenchyma with neutrophilic infiltrate (b).
case_images: crg-2024-0018-0001-536619_F03.jpg
case_images: PMC10948173_01_crg-2024-0018-0001-536619_F03.jpg
case_images: F3
case_images: The H&E stain from the aspirate showed inflamed and degenerating liver parenchyma with scant identifiable portal tracts and abundant fibrinopurulent inflammation; however, the resultant cultures showed no growth (shown in Fig. 3).