case_images: PMC9951897_01
case_images: PMC9951897_02
case_images: Abdominal CT showing slightly hypoechoic heterogenous solid mass in the subcapsular region of the posterior segment of the right lobe of the liver (see arrow).
case_images: hf-4-037-g001.jpg
case_images: PMC9951897_02_hf-4-037-g001.jpg
case_images: F1
case_images: An abdominal CT disclosed a heterogenous, lobular, slightly hypoechoic mass of size 27 x 27 mm located in the subcapsular region of the posterior segment of the right lobe close to segment VI of the liver (Fig. 1).
case_images: (a) Abdominal MRI T2 showing a mass hypointense in the center and hyperintense in the periphery at segment VI of the liver. (b) Dynamic contrast MRI enterography showing the progression of this lesion 3 months after the first abdominal MRI (see arrow).
case_images: hf-4-037-g002.jpg
case_images: PMC9951897_02_hf-4-037-g002.jpg
case_images: F2
case_images: Abdominal magnetic resonance imaging (MRI) with contrast confirmed the presence of a round lesion with a diameter of 25.6 mm on its short axis, with a necrotic center and straight, thick contours located at the posterior of segment VI of the liver (Fig. 2a).
case_images: (a) ocalized necrotizing granulomatous lesion (HE 100x). (b) Fibrous tissue surrounding a center of fibrinoid necrosis and hyalinizing fibrotic areas of the central necrotic area (Masson's trichrome 200x). (c) Surrounding granulomatous inflammation (HE 400x).
case_images: hf-4-037-g003.jpg
case_images: PMC9951897_02_hf-4-037-g003.jpg
case_images: F3
case_images: At the histologic examination of the mass, a localized necrotizing granulomatous lesion suggestive of a rheumatoid nodule was observed (Fig. 3a). Masson's trichrome stain demonstrated the nodule consisted of fibrous tissue surrounding a center of fibrinoid necrosis and the focal hyalinizing fibrotic areas of the central necrotic area (Fig. 3b). There was a surrounding palisade of histiocytes, fibroblasts, and mixed infiltrate of lymphocytes, plasma cells and occasional eosinophils and neutrophils (Fig. 3c).