case_images: PMC10896603_01
case_images: Preoperative contrast-enhanced CT showed a nodular and significantly enhanced lesion located in the right lobe of the liver during the arterial phase (A), with reduced enhancement in the portal and delayed phases (B, C). Preoperative Contrast-enhanced magnetic resonance imaging. Plain scan: T1W1 shows low signal intensity (D), Enhanced scan: obvious enhancement in arterial phase (E), less enhancement in portal phase and delayed phase than in surrounding liver parenchyma (F). Six months after surgery, the results of contrast-enhanced CT examination did not reveal any notable abnormalities: arterial phase (G); Venous phase (H); Z Effective (I). The tumor is indicated by red arrow.
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case_images: f1
case_images: Contrast-enhanced magnetic resonance imaging (MRI) revealed a nodular mass in the right lobe of the liver with an enhancement pattern that appeared as fast-in and fast-out, leading to a diagnosis of hepatocellular carcinoma ( Figures 1D-F ). The degree of strengthening at the portal vein stage and the delayed stage was reduced, indicating hepatic cancer ( Figures 1A-C ). A six-month postoperative follow-up involving an enhanced CT scan of the abdomen revealed no evidence of disease recurrence, confirming the effectiveness of the treatment ( Figures 1G-I ).
case_images: Intraoperative condition (A). Completely resected tumor (B).
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case_images: During the surgical intervention, an irregularly encapsulated tumor was identified adhering to the root of the right triangular ligament in the liver's posterior lobe, in close proximity to the right renal capsule. ( Figure 2A ). The nodules are solid and soft, with a complete capsule covering their surface, and they appear grayish-red upon sectioning ( Figure 2B ).
case_images: Histopathological and immunohistochemical findings, Histopathological examination (A, B): "onion skin-like" structure. Immunohistochemical examination: CD21 was present in the concentric follicular dendritic cell networks (C). CD3 was scattered positively among the T cells (D). CD20 was scattered positively among the B cells (E). KI67 showed high expression in the germinal center and low expression outside the germinal center (F). Magnification x100 (panels A); x200 (B-F).
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case_images: f3
case_images: Additionally, there is vascular proliferation and hyalinization present in the interfollicular zones, as well as scattered follicular dendritic cells and plasma cells ( Figure 3 ). CyclinD1 ( Figure 3 ). Collectively, these immunohistochemical findings corroborate the diagnosis of HV-CD.