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A 49 year-old woman was found to have a 2.9 cm hepatic lesion in segment 8, initially identified on an abdominal ultrasound performed for chronic abdominal pain and new onset diabetes mellitus, type 2. On computed tomography study the lesion was arterial enhancing with washout on portal venous and delayed phase and was classified as a LI-RADS category 4 (LR-4), suggestive but not diagnostic of hepatocellular carcinoma (HCC); the remainder of the exam was normal with no evidence of metastatic deposits. Of note, the background liver did not show any features of advanced fibrosis, but the patient had a past medical history of non-alcoholic fatty liver disease (NAFLD). The patient subsequently underwent a partial hepatectomy and on gross examination a well circumscribed grey tan lesion was identified. Histologically, the lesion showed a nested architecture, composed of epithelioid cells with round to oval nuclei, variable nucleoli and prominent granular eosinophilic cytoplasm (Figures 1A and 1B; * denotes background normal hepatic parenchyma). In areas the tumoral cells condensed around blood vessels (Figure 1B). The lesion also showed prominent fibrous trabeculae and pericellular fibrosis, raising the morphological differential diagnosis of a scirrhous or fibrolamellar subtype of hepatocellular carcinoma.

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2016-06-24   |   214 visitas   |   Evalua este artículo 0 valoraciones

Vol. 15 Núm.3. Mayo-Junio 2016 Pags. 436-437 Ann Hepatol 2016; 15(3)