Multifocal intraportal invasion of breast carcinoma diagnosed by laparoscopy-assisted liver biopsy

Figure 1 A: Enhanced CT scan on April 2, 2003. A metastatic lesion in liver S₂ (arrowhead). B and C: Enhanced magnetic resonance image with Ferridex on May 19, 2003. Metastatic lesions in S₂ (B, arrowhead) and S₆ (C, arrowhead). D-I: Dynamic study by CT scan on admission. Uneven enhancement effect of the liver in late phase.

Figure 2 Irregular and deformed liver surface with multiple indentations and shallow linear depressions (A and B: right lobe, C and D: left lobe). A wide scar on the surface of S₂ at the site where metastatic tumor existed before chemotherapy (E, arrowheads).

Figure 3 A: Laparoscopic liver biopsy from a wide scar lesion showed residual cancer cells scattered in a wide fibrous band in one area (hematoxylin and eosin (HE) stain). B and C: In another area intraportal tumor thrombi were clearly demonstrated. Endothelial cells were stained brown by CD31 immunohistochemistry (B, HE stain, C, CD31 immunohistochemical stain). D and E: Cancer cells showed desmoplastic change around them, which extended toward the sinusoids (D, HE stain, E, Masson’s trichrome stain). F: Original breast cancer. Note desmoplastic change around the tumor cells (HE stain).