maligne Lebertumoren

Three cases

of histologically proven hepatic epithelioid hemangioendothelioma evaluated using a second-generation microbubble contrast medium in ultrasonography: case reports. a Conventional abdominal ultrasonography (US) in case 1 showed multiple low echoic liver nodules (arrow) with a vague margin, and nodules located in the peripheral sites tended to coalesce with each other. The vascular pattern inside the nodules was not precisely visible in the arterial dominant phase of contrast-enhanced computed tomography (CECT) (b). c The apparent diffusion coefficient (ADC) mapping in case1 is shown. d In the diffusion-weighted imaging (DWI) at a b score of 1000 (sec/mm2), the peripheral area of the nodules in case1 showed a much higher intensity than its central lesion. e SonazoidⓇ contrast enhanced US (CEUS) in case1 showed the vascularity (arrow) in the early vascular phase, but the vascular pattern is not specified. f Later in the portal venous and late phases (PVLP) and post vascular phase, they were defective. g Defect re-perfusion imaging clearly showed that the nodules were gradually enhanced from the peripheral sites as ringed enhancement. h Photomicrograph of a histological section of a hepatic specimen obtained via percutaneous liver needle biopsy in case 1 (200× with hematoxylin and eosin stain) is shown. i A high number of epithelioid tumor cells with spindle-shaped nuclei, form intracellular vascular lumina (arrow) (800× with hematoxylin and eosin stain). In immunostaining (200×), the sample was positive for cluster of differentiation (CD) 31 (j) and CD34 (k)