J Korean Soc Radiol.  2016 Nov;75(5):389-393. 10.3348/jksr.2016.75.5.389.

Imaging Findings of a Primary Paraganglioma of the Liver: A Case Report

• Ji SW
• Kang UR
• Park JB

• KMID: 2355993
• DOI: http://doi.org/10.3348/jksr.2016.75.5.389

Abstract

Primary hepatic paraganglioma is an extremely rare type of tumor originating from extra-adrenal chromaffin cells. We report a case of primary intrahepatic paraganglioma in a 52-year-old man, with pathologic confirmation through right hepatectomy. An imaging study indicated a predominately hemorrhagic septated cystic mass and peripheral marked enhancement of the solid portions, which showed persistent enhancement.

MeSH Terms

Chromaffin Cells
Hepatectomy
Humans
Liver*
Magnetic Resonance Imaging
Middle Aged
Paraganglioma*

Figure

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  Fig. 1 A 52-year-old man presented with primary paraganglioma of the liver. A. Dynamic liver CT shows that the mass displays an enhanced septum with marked peripheral enhancement in the arterial phase. B. Ultrasonography shows a septated cystic mass with a peripheral hypoechoic lesion and no vascularity on Doppler examination.

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  Fig. 2 MRI of primary paraganglioma of the liver in a 52-year-old man. The mass is hypointense on axial T1-weighted image (A). The lesion exhibits intense peripheral rim enhancement during the arterial phase (B), isointensity during the portal phase (C), and shows a defect during the hepatobiliary phase (D). Heavily T2-weighted image (E) and DWI (F) show heterogeneous high signal intensity, and the cystic portion also shows fluid-fluid levels that were indicative of hemorrhage. DWI = diffusion weighted image

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  Fig. 3 Histology of primary paraganglioma of the liver. A. On the left side of the figure, the tumor comprises of large polygonal cells with distinctive basophilic cytoplasm, characteristic of paraganglioma. The tumor is in contrast with the liver parenchyma that contains eosinophilic normal liver cells on the right side. Between the two, there is a thin fibrous septum (hematoxylin and eosin stain, × 200). B. Electron microscopic examination shows multiple neurosecretory granules (arrowheads).

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