Figure 1. The computed
tomography (CT) and magnetic resonance imaging (MRI) findings.a : The portal vein seemed to be interrupted at the liver hilum
and flow into inferior vena cava, merging with the hepatic vein (arrow).b : The liver parenchyma showed poor contrast and the
intrahepatic portal vein was unclear in the portal phase, c :
The irregular parenchyma disappeared in the late phase. d, e :
At the lower margin of segment 6, the tumor (arrow) showed enhancement
from the margin (d) and staining continued until the late phase (e).f : The tumor showed high signal intensity on T2-weighted MRI.
Figure 2. The magnetic resonance imaging (MRI) findings.a, b, c: Superparamagnetic iron oxide (SPIO)-enhanced MRI. A
tumor was detected in segment 4. This tumor showed low signal intensity
after SPIO enhancement and the central portion showed high signal
intensity. (a ), (b ): One year after the first visit.
(c) : Two years after the first visit. d , e ,f : gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid
(EOB)-enhanced MRI at 3.5 years after the first visit. The tumor showed
faint staining in the early phase (d ), unclear in the portal
phase (e ) and central low intensity in the hepatocyte phase
(f ).
Figure 3. The magnetic resonance imaging (MRI) findings of the
tumor located in segment 7. a , b : Three years after
the first visit. The tumor showed faint staining in the early phase
(a ), and low to iso intensity in the hepatocyte phase
(b ). c, d, e : This tumor gradually grew, although the
growth rate was slow. During the course, hypervascular areas were
observed in the arterial phase and washout was observed in the late
phase. (c) : Four years after the first visit. (d) :
Five years after the first visit. (e) : Six years after the
first visit.
Figure 4. Autopsy findings. a: The portal vein was
interrupted at the liver hilum and flowed directly into the hepatic
vein. b : Microscopic findings of the tumor lesion demonstrated
well to moderately differentiated HCC. c : Part of the tumor
cells showed foamy cytoplasm and contained fat droplets. d : The
histology of the background liver showed cholestasis, fibrosis around
portal vein and central vein, and ductular proliferation. H.E.,
hematoxylin and eosin staining.