case_images: PMC3891746_01
case_images: Non-FDG avid liver lesion on PET/CT.
case_images: CRIM.MEDICINE2013-904126.001.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.001.jpg
case_images: fig1
case_images: Patient worked as a nurse, and due to vague generalized symptoms she insisted on PET scan to be done which revealed a nonmetabolically active lesion in the liver, slightly less metabolically active than the surrounding liver parenchyma, with no other lesions being identified on PET scan as a primary site (Figure 1).
case_images: T1 hypointense liver lesion on MRI.
case_images: CRIM.MEDICINE2013-904126.002.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.002.jpg
case_images: fig2
case_images: A dedicated liver MRI revealed a hypervascular lesion with irregular lobulated margins in the anterior right lobe of the liver near the falciform ligament that was T1 hypotense (Figure 2) and T2 hypertense (Figure 3) with heterogeneous increased enhancement during arterial phase with a fairly rapid washout.
case_images: T2 hyperintense liver lesion on MRI.
case_images: CRIM.MEDICINE2013-904126.003.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.003.jpg
case_images: fig3
case_images: A dedicated liver MRI revealed a hypervascular lesion with irregular lobulated margins in the anterior right lobe of the liver near the falciform ligament that was T1 hypotense (Figure 2) and T2 hypertense (Figure 3) with heterogeneous increased enhancement during arterial phase with a fairly rapid washout.
case_images: Haphazard arrangement of epithelioid cells with cleared-out cytoplasm.
case_images: CRIM.MEDICINE2013-904126.004.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.004.jpg
case_images: fig4
case_images: On H&E staining a haphazard arrangement of epithelioid and spindle cells with cleared-out cytoplasm was seen (Figure 4).
case_images: Melan-A stain.
case_images: CRIM.MEDICINE2013-904126.005.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.005.jpg
case_images: fig5
case_images: The tumor on immunohistochemistry staining was strongly positive for Melan-A (Figure 5) and HMB-45 (Figure 6) and negative for S-100, Hepar-1, ER, PR, desmin, CK7, CK20, CD10, CD117, CD31, synaptophysin, and vimentin.
case_images: HMB-45 stain.
case_images: CRIM.MEDICINE2013-904126.006.jpg
case_images: PMC3891746_01_CRIM.MEDICINE2013-904126.006.jpg
case_images: fig6
case_images: The tumor on immunohistochemistry staining was strongly positive for Melan-A (Figure 5) and HMB-45 (Figure 6) and negative for S-100, Hepar-1, ER, PR, desmin, CK7, CK20, CD10, CD117, CD31, synaptophysin, and vimentin.