case_images: PMC10559554_01
case_images: A 62-year-old woman with incidentally detected multiple hepatic lesions. (a) Abdominopelvic computed tomography was revealed the innumerable nodular arterial enhancing hepatic lesions in early phase (b) with washout enhancement pattern in delayed phase.
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case_images: PMC10559554_01_JCIS-13-29-g001.jpg
case_images: F1
case_images: Abdominopelvic computed tomography (CT) revealed multiple nodular arterial enhancing hepatic lesions in the early phase [Figure 1a] with washout enhancement pattern in the delayed phase [Figure 1b].
case_images: A 62-year-old woman with incidentally detected multiple hepatic lesions. (a) On the axial fat-suppressed T1-weighted magnetic resonance (MR) images, the innumerable well-defined nodular lesions showed hypointensity relative to the background liver tissue. (b) Dynamic contrast-enhanced MR images, the hepatic lesions showed arterial enhancement (c-d) and had washout enhancement pattern in portal and delayed phase. (e) On the hepatobiliary phase, the hepatic lesions showed low signal intensity. (f) On the axial fat-suppressed T2-weighted MR images hepatic lesions showed hyperintensity. (g) Diffusion weighted image (DWI) at b-value of 800 s/mm2 reveal high signal intensity. (h) And an apparent diffusion coefficient (ADC) map reveal a low ADC value.
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case_images: F2
case_images: T1-weighted image [Figure 2a]. The hepatic lesions showed enhancement in the arterial phase [Figure 2b] and a washout enhancement pattern in the portal and delayed phase [Figure 2c and d]. In the hepatobiliary phase, the hepatic lesions showed low-signal intensity [Figure 2e]. T2-weighted images, the hepatic lesions showed hyperintensity [Figure 2f]. The hepatic lesions showed high-signal intensity on diffusion-weighted image and a low apparent diffusion coefficient value [Figure 2g and h]. The hepatic lesions showed no loss of signal on out-of phase versus in-phase images.
case_images: A 62-year-old woman with incidentally detected multiple hepatic lesions. Whole-body positron emission tomography-computed tomography revealed multiple hypermetabolic lesions (SUV max 8.8) in liver.
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case_images: PMC10559554_01_JCIS-13-29-g003.jpg
case_images: F3
case_images: Whole-body positron emission tomography-CT (PET-CT) revealed multiple hypermetabolic lesions (SUV max 8.8) in the liver [Figure 3] and multiple hypermetabolic lesions (SUV max 9.6) along whole skeletal systems.
case_images: A 62-year-old woman with incidentally detected multiple hepatic lesions. On the ultrasonography, the hepatic lesion (arrow and stars) was seen target appearance.
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case_images: F4
case_images: Ultrasound (US) revealed numerous nodular lesions with a target appearance [Figure 4].
case_images: A 62-year-old woman with incidentally detected multiple hepatic lesions. (a) A core biopsy of hepatic nodule shows infiltration by atypical plasmacytoid cells (Hematoxylin-Eosin stain) (b) and immunohistochemical staining for CD138 confirms plasma cell infiltration. (c) Plasma cells demonstrate kappa light chain restriction by immunohistochemistry for immunoglobulin kappa (d) and lambda light chains.
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case_images: PMC10559554_01_JCIS-13-29-g005.jpg
case_images: F5
case_images: A US-guided gun biopsy was performed using an 18-gauge needle, and a pathologic examination revealed a plasma cell neoplasm [Figures 5a-d].