case_images: PMC5937564_01
case_images: A chest X-ray showing no mediastinal mass and normal lung parenchyma. Generalized osteopenia was identified at the vertebral area.
case_images: CRIPE2018-6828037.001.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.001.jpg
case_images: fig1
case_images: Chest X-ray showed generalized osteopenia (Figure 1).
case_images: CT chest and whole abdomen (coronal view) showing marked hepatosplenomegaly, enlarged size of the pancreas, and numerous heterogeneous masses at both lobes of the liver and the pancreas.
case_images: CRIPE2018-6828037.002.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.002.jpg
case_images: fig2
case_images: CT chest and whole abdomen (Figures 2 and 3) revealed hepatomegaly and numerous heterogeneous low-attenuation centers varying in size, with peripheral rim-enhancing masses scattered in both hepatic lobes, and the largest one was 8 x 7.5 x 11.6 cm in size.
case_images: CT chest and whole abdomen (axial view). (a) Multiple masses at both lobes of the liver, the spleen, and the pancreatic body and tail. (b) The largest hepatic mass of 8 x 7.5 x 11.6 cm in diameter.
case_images: CRIPE2018-6828037.003.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.003.jpg
case_images: fig3
case_images: CT chest and whole abdomen (Figures 2 and 3) revealed hepatomegaly and numerous heterogeneous low-attenuation centers varying in size, with peripheral rim-enhancing masses scattered in both hepatic lobes, and the largest one was 8 x 7.5 x 11.6 cm in size.
case_images: Liver biopsy revealing proliferation of atypical tubular elements associated with fibrous stroma characteristic of cholangiocarcinoma. H&E staining, original magnification: (a) x10 and (b) x40.
case_images: CRIPE2018-6828037.004.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.004.jpg
case_images: fig4
case_images: Histological examinations of fine-needle biopsy showed poorly differentiated tubular adenocarcinoma (Figure 4).
case_images: The bile canalicular immunohistochemical staining pattern in cholangiocarcinoma with diffuse positivity in cytoplasmic membrane staining of CK7 (a) and CK19 (b).
case_images: CRIPE2018-6828037.005.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.005.jpg
case_images: fig5
case_images: Immunohistochemical staining showing lack of the monoclonal CEA (a) and the polyclonal CEA (b).
case_images: CRIPE2018-6828037.006.jpg
case_images: PMC5937564_01_CRIPE2018-6828037.006.jpg
case_images: fig6