case_images: PMC2822180_01
case_images: MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)
case_images: CJ-06-25-g001.jpg
case_images: PMC2822180_01_CJ-06-25-g001.jpg
case_images: F0001
case_images: The mass lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images [Figure 1].
case_images: Photomicrographs from aspiration smears from hepatic mass demonstrating singly lying polygonal cells (a, Papanicolaou x 100). A cellular fragment with one cell showing an intranuclear inclusion (arrow) is seen (b, Papanicolaou x 100). The polygonal cells display moderate nuclear pleomorphism (c, May-Grunwald-Giemsa stain x 200). Higher-power view shows an intranuclear inclusion marked by arrow (d, May-Grunwald-Giemsa stain x400)
case_images: CJ-06-25-g002.jpg
case_images: PMC2822180_01_CJ-06-25-g002.jpg
case_images: F0002
case_images: The aspiration smears were paucicellular and showed single cells and occasional small tissue fragments [Figure 2a-c]. In addition, scattered larger malignant-appearing pleomorphic cells with moderate amount of cytoplasm and hyperchromatic nucleus were noted [Figure 2a]. Sharply-defined intranuclear pseudoinclusions were noted in many cells [Figure 2b, d].
case_images: Histological photomicrographs demonstrating singly-lying and cords of cells embedded in a desmoplastic stroma (a, H and E x100). The tumor cells show intracytoplasmic lumina containing red blood cells (b, H and E x200). Immunostaining reveals cytoplasmic positivity for CD31 in the tumor cells (c, x100) and focal positivity for pancytokeratin (d, x200).
case_images: CJ-06-25-g003.jpg
case_images: PMC2822180_01_CJ-06-25-g003.jpg
case_images: F0003
case_images: Biopsy section showed a small fragment of liver parenchyma along with fibrous tissue infiltrated by scattered tumor cells [Figure 3a]. Prominent intracytoplasmic vacuoles were seen in many tumor cells [Figure 3b]. Immunohistochemistry revealed the tumor cells to be strongly and diffusely positive for CD31 [Figure 3c] and CD34 with focal reactivity for pancytokeratin [Figure 3d].