case_images: PMC10155027_01
case_images: Multiphasic MRI showing hepatic mass (letter A).. Abbreviation: MRI, magnetic resonance imaging.
case_images: 10.1177_23247096231165744-fig1.jpg
case_images: PMC10155027_01_10.1177_23247096231165744-fig1.jpg
case_images: fig1-23247096231165744
case_images: Further imaging was pursued with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the abdomen that confirmed a large heterogeneous mass in the lateral-segment left lobe of the liver measuring 12 x 6.5 cm, an extensive portal vein thrombosis, portal, and peripancreatic lymphadenopathy which were concerning for malignant cause (Figures 1 and 2).
case_images: Multiphasic MRI showing portal vein thrombosis (letter c) and heterogenous
  hepatic mass (blue arrow).. Abbreviation: MRI, magnetic resonance imaging.
case_images: 10.1177_23247096231165744-fig2.jpg
case_images: PMC10155027_01_10.1177_23247096231165744-fig2.jpg
case_images: fig2-23247096231165744
case_images: Further imaging was pursued with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) of the abdomen that confirmed a large heterogeneous mass in the lateral-segment left lobe of the liver measuring 12 x 6.5 cm, an extensive portal vein thrombosis, portal, and peripancreatic lymphadenopathy which were concerning for malignant cause (Figures 1 and 2).
case_images: (A) (B) Cytology smear with Diff-Quik stain showing nests of malignant cells
  with increased nuclear-cytoplasmic ratio and marked nuclear
  pleomorphism.
case_images: 10.1177_23247096231165744-fig3.jpg
case_images: PMC10155027_01_10.1177_23247096231165744-fig3.jpg
case_images: fig3-23247096231165744
case_images: A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).
case_images: (A) Routine hematoxylin and eosin staining of FFPE biopsies at increasing
  magnification displaying malignant cells diffusely distributed throughout
  the sample. (B) High-power view of malignant cells infiltrating the stroma
  with strong nuclear staining and mitotic figures within pleomorphic
  nuclei.. Abbreviation: FFPE, formalin-fixed-paraffin-embedded.
case_images: 10.1177_23247096231165744-fig4.jpg
case_images: PMC10155027_01_10.1177_23247096231165744-fig4.jpg
case_images: fig4-23247096231165744
case_images: A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).
case_images: Immunohistochemical staining of tissue biopsy: (A) Broad positivity (brown)
  for hepatocyte stain of the malignant cells. (B) Strong focal positivity
  (brown) of the malignant cells for cytokeratin-7. (C) Negative staining for
  glypican throughout the tissue sample.
case_images: 10.1177_23247096231165744-fig5.jpg
case_images: PMC10155027_01_10.1177_23247096231165744-fig5.jpg
case_images: fig5-23247096231165744
case_images: A biopsy of the hepatic lesion guided by CT was then obtained, which revealed lobular aggregates of hepatocytes with moderate nuclear atypia and disorganization and strong stain expression for the hepatocyte stain (hep par 1) and cytokeratin 7, while glypican 3, CD 10, and Carcinoembryonic antigen (CEA) were negative, confirmatory for HCC (Figures 3-5).