Korean J Radiol.  2016 Oct;17(5):758-762. 10.3348/kjr.2016.17.5.758.

Hepatic Involvement of Histiocytic Sarcoma: CT and MRI Findings

• Kubo T
• Kiryu S
• Akai H
• Ota Y
• Tojo A
• Yoshida H
• Kato N
• Nakano Y
• Ohtomo K

• KMID: 2458068
• DOI: http://doi.org/10.3348/kjr.2016.17.5.758

Abstract

Histiocytic sarcoma in the liver is an extremely rare hematological malignancy. Herein, we reported the case of a 68-year-old woman who presented with characteristic wedge-shaped abnormality bounded by hepatic veins on computed tomography and magnetic resonance imaging of the liver. In the wedge-shaped area, decreased portal flow and the deposition of iron were observed. These imaging findings are consistent with intrasinusoidal tumor cell infiltration. A liver biopsy was performed, and histiocytic sarcoma was confirmed histopathologically.

Keyword

Histiocytic sarcoma; Magnetic resonance imaging; Computed tomography; Liver

MeSH Terms

Aged
Biopsy
Female
Histiocytic Sarcoma/*diagnostic imaging/pathology
Humans
Liver Neoplasms/*diagnostic imaging/pathology
Magnetic Resonance Imaging/methods
Retrospective Studies
Tomography, X-Ray Computed/methods

Figure

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  Fig. 1 Dynamic study CT.A. Precontrast CT shows slightly hypoattenuating mass in right lobe of liver (arrow). B. On arterial phase, faint enhancement is seen in this area (arrow). C. Most of area was enhanced as normal liver parenchyma on delayed phase (arrow).

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  Fig. 2 MR images of liver.A. Ill-defined hyperintense signal area was found in wedge-shaped dark signal intensity area on fat-suppressed T2WI. B-D. Signal intensity was lower on in-phase images (B) than on out-of-phase images (C) in area corresponding to ill-defined hyperintense signal on fat-suppressed T2WI. Surrounding area showed low signal due to iron deposition (D). On ADC map, restricted diffusion was absent. E. After Gd-EOB-DTPA injection, enhancement (arrow) was surrounded by wedge-shaped faint enhancement (arrowheads) on arterial phase. F. Well-defined wedge-shaped decrease in Gd-EOB-DTPA was found on hepatobiliary phase. ADC = apparent diffusion coefficient, Gd-EOB-DTPA = gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid, T2WI = T2-weighted image

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  Fig. 3 Hematoxylin and eosin and immunohistochemically stained sections from liver tumor (x 200).Tumor cells showed large pleomorphic nuclei (A) and positive staining for CD68 (B) and CD163 (C). Hepatocytes were positive for iron (D).

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