case_images: PMC10769864_01
case_images: Representative graphical output of the next-generation sequencing analysis, showing an exon 11 deletion of KIT (Gln556_Val559del). The different colors are referred to the single DNA basis.
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case_images: The molecular analysis performed with next-generation sequencing (NGS) analysis showed an exon 11 deletion of KIT (Gln556_Val559del) ( Figure 1 ).
case_images: Basal axial CT scan evaluation, showing a hypodense and partially colliquated liver lesion at segments II-III (arrow).
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case_images: During the surveillance program, a computer tomography (CT) scan performed in July 2022 showed a wide liver lesion at II-III hepatic segments with metastatic features ( Figure 2 ).
case_images: (A) Basal axial PET/CT fused images, showing a hypermetabolic lesion involving II-III liver segments (SUVmax 9.4). (B) Axial PET/CT fused images, restaging scan after a month of imatinib therapy: the hypermetabolic area appears increased in size and shows a greater 18F-FDG uptake: SUVmax 20.1 (vs. 9.4).
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case_images: The subsequent 18FDG-PET/CT confirmed the presence of a hypermetabolic liver lesion with a maximum standardized uptake value (SUVmax) of 9.4 ( Figure 3 ). The subsequent 18FDG-PET/CT performed 1 month later for the early treatment response evaluation, given the concomitant chronic MPN already previously treated with imatinib, showed a metabolic progression of the liver lesion, presenting an SUVmax of 20.1 ( Figure 3 ).
case_images: (A, B) H&E x4: histologic features of the liver biopsy showing a vascular tissue with bland spindle cell fibroblast with collagenous stroma, admixed with a variable number of inflammatory elements (granulation tissue). (C, D) Immunohistochemical stain for DOG-1 (C) and CD117 (D) was all negative.
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case_images: The histological examination has displayed liver tissue associated with paucicellular lesion of collagenized neovascularized fibrous-edematous stroma with lymphogranulocytic inflammatory infiltrate, such as granulation tissue ( Figure 4 ).
case_images: (A) Axial CT scan evaluation after 3 months of imatinib treatment (arrow), showing a partial response of liver lesion. (B) Axial PET/CT fused images scan, after 3 months of imatinib treatment, showing a marked decline in both lesion size and 18F-FDG uptake (SUVmax 7.9).
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case_images: f5
case_images: The subsequent abdominal CT scan and 18FDG-PET/CT, performed in October 2022, 2 months after the beginning of therapy, revealed both a morphologic and metabolic partial response of the liver lesion, with an SUVmax of 7.9 ( Figures 5A, B ).