Acute progressing hepatic angiosarcoma: An autopsy case report

Figures

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  Fig. 1. Contrast-enhanced computed tomography (CT). (A) Precontrast (B) Early phase (C) Delayed phase Precontrast CT image showed swelling of the hepatic right lobe and multiple low-density mass-like structures in the liver (Fig. 1A). On dynamic contrast enhanced CT images, these lesions showed multiple nodular enhancement in the early-phase (Fig. 1B), and retained or fill-in pattern enhancement in the delayed phase. The lesions that demonstrated both homogeneous and heterogeneous enhancement coexisted (Fig. 1C).

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  Fig. 2. Contrast-enhanced MRI. Gd-EOB-DTPA-enhanced MR images showed multiple nodular enhancement of those lesions in the early phase, and followed by gradual fill-in enhancement in the portal and late phase. Enhanced still retained in the hepatocyte phase. Gd-EOB-DTPA, gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid.

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  Fig. 3. (A) Hepatic arteriography Hepatic arteriography showed multiple foci of dense and nodular contrast opacification that are so called “cotton-wool appearance”. (B) CT during arterial portography (CTAP). CTAP showed heterogenous contrast-enhancement that suggested blood supply from the portal vein into the masses.

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  Fig. 4. Autopsy specimens. (A) Entire liver (B) Cut surface of the liver (C) H&E stained liver section at low magnification (D) H&E stained liver section at high magnification. The liver was swollen. On the cut surface of the liver, there were multiple, cystic areas of varying sizes that contained blood, along with some areas of hemorrhage and necrosis. Hematoxylin-Eosin (HE) staining showed proliferation of spindle cells surrounded by hepatocytes.