Department of Pathology, University of Oklahoma Health Sciences Center
A 21 year-old woman with a hepatic mass.
Clinical information: The patient was a 21 year-old female who complained of multiple episodes of epigastric discomfort with nausea and vomiting. An ultrasound examination was performed and revealed a hepatic mass in the left lobe of liver. A CT scan revealed a well defined mass that occupied most of the left lobe of the liver. The mass was excised. The followings are representative images of the specimen.
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Pathology of the case:
The gross specimen as illustrated in Panel A is 242 gram and 11.0 x 8.0 x 5.5 cm. The lesion is a well defined nodule that can be easily shelled out during surgery. The cross section is composed of pale yellow-brown nodules of similar size and separated by thin fibrous septa. In one area, there is also a stellate fibrotic scar.
Histologically, the grossly notable nodules correspond to islands of cells separated by dense fibrous tissue (Panel B). On medium magnification, the islands of cells have smooth, pushing margins (Panel C). The cells are quite similar to normal hepatocytes except that these islands do not have the general architecture of normal liver (Panel D). Loss of the liver plate structure is well illustrated by reticulin stain (Panel G). In some areas there are some entrapped ductular structure consistent with bile canaliculi (Panel E and F) and their identity is confirmed by immunohistochemistry for cytokeratin 7 (Panel H and I).
| DIAGNOSIS: Focal nodular hyperplasia. |
Discussion: In Preparation
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