case_images: PMC10864056_01
case_images: Macroscopic appearance of the ectopic liver lobes. After the liver is dissected, the diaphragm is observed from the abdominal side. Two 1-cm brownish masses are arranged in juxtaposition (arrows); two masses were distinct. No continuity between the masses and diaphragm was detected. The asterisk indicates an esophageal hiatus.
case_images: cureus-0016-00000052270-i01.jpg
case_images: PMC10864056_01_cureus-0016-00000052270-i01.jpg
case_images: FIG1
case_images: At autopsy, two adjacent 1-cm masses were found near the inferior vena cava (Figure 1).
case_images: Architecture of the ectopic liver lobe. (a) The ectopic liver lobe is covered with fibrous capsules. Arrowheads indicate Glisson's sheath. (b) An outflow bile duct (arrows) and medium-sized blood vessels (arrowheads) are seen, mimicking porta hepatis. (c) Additional sectioning of perihepatic tissue revealed a 1-mm duct with the appearance of a bile duct connecting the ectopic liver lobe with the common bile duct.
case_images: cureus-0016-00000052270-i02.jpg
case_images: PMC10864056_01_cureus-0016-00000052270-i02.jpg
case_images: FIG2
case_images: The surface of each mass was covered by a fibrous capsule, and each mass was composed of liver tissue consisting of hepatic lobules and Glisson's sheath, which led to the diagnosis of an ectopic liver lobe (Figure 2, Panel a). Structures mimicking the porta hepatis, consisting of a bile duct and medium-sized blood vessels (thick-walled artery and dilated thin-walled vein), were also detected (Figure 2, Panel b). Additional investigation of the perihepatic tissue suggested continuity of the outflow bile duct with the common bile duct, but the continuity of the medium-sized blood vessels was unclear (Figure 2, Panel c).
case_images: Histological features of the ectopic liver lobe. (a,b) Central vein walls (arrows) are thickened by fibrosis (a: HE stain, b: Azan stain). (c) High-power view of Figure 3b. Portal fibrosis is prominent, and portal veins are unclear. (d) No capillarization of sinusoids is detected by immunohistochemistry (IHC) for CD34. (e) The formation of biliary canaliculi is confirmed by IHC for CD10. (f) IHC for cytokeratin 7. A ductular reaction is present.
case_images: cureus-0016-00000052270-i03.jpg
case_images: PMC10864056_01_cureus-0016-00000052270-i03.jpg
case_images: FIG3
case_images: Panels a and b). Portal fibrosis was prominent and narrowing of portal veins was seen, mimicking portal venopathy (Figure 3, Panel c). The sinusoids were not dilated, and no capillarization of sinusoids was detected by immunohistochemistry (IHC) for CD34 (Figure 3, Panel d). There was no biliary stasis, and the formation of biliary canaliculi was confirmed by IHC for CD10 (Figure 3, Panel e), although the proliferation of bile ductules was observed, mimicking the ductal plate (Figure 3, Panel f).
case_images: Immunohistochemistry for glutamine synthetase (GS). Central veins are surrounded by GS-positive hepatocytes as seen in normal liver tissue.
case_images: cureus-0016-00000052270-i04.jpg
case_images: PMC10864056_01_cureus-0016-00000052270-i04.jpg
case_images: FIG4