case_images: PMC10884622_01
case_images: Abdominal axial CT scan showing a hypointense lesion (arrow) in segment IVb of the right liver (a), the lesion does not show enhancement after contrast injection (b).
case_images: cureus-0016-00000052835-i01.jpg
case_images: PMC10884622_01_cureus-0016-00000052835-i01.jpg
case_images: FIG1
case_images: Abdominal CT scan revealed a solitary and hypodense lesion in segment IVb of the liver, approximately 22mm in size, with no enhancement after contrast injection (Figure 1).
case_images: Photomicrographs of the solitary necrotic nodule (first patient) show a central necrotic core surrounded by a peripheral thick and fibrous capsule (a: H&E, x40). Silver stain reveals a well preserved reticulin meshwork in the necrotic core (b). Trichrome stain demonstrates the fibrous nature of the peripheral capsule (c). The necrotic metastasis (second patient) shows the same morphological characteristics as a solitary necrotic nodule (d: H&E, x40). The reticulin meshwork is completely absent in the necrotic center, demonstrated by a negative silver stain (e). Cytokeratin immunostaining reveals residual and partially necrotic glands in the background, confirming the metastatic nature of the lesion (f). . H&E: Hematoxylin and Eosin Stain
case_images: cureus-0016-00000052835-i02.jpg
case_images: PMC10884622_01_cureus-0016-00000052835-i02.jpg
case_images: FIG2
case_images: The adjacent liver tissue was found to be normal without any signs of malignancy (Figure 2A). Further analysis of the lesion using silver stain revealed a well-preserved reticulin network within the necrotic area (Figure 2B), while Trichrome stain confirmed the fibrous nature of the surrounding capsule (Figure 2C). To highlight the importance of immunostaining, we added the case of a solitary nodule of the liver in a patient with a colorectal carcinoma, the histomorphological examination of the lesion revealed the same morphological pattern as shown in the first case, with a completely necrotic nodule, surrounded by a fibrous capsule, with no viable tumor cells or glands (Figure 2D), silver nitrate stain was negative in the necrotic core, and it did not show the characteristic reticulin meshwork of the normal liver parenchyma (Figure 2E); the use of a cytokeratin (CK) immunostain clearly highlighted some abnormal and partially necrotic glands (Figure 2F).