Well to moderately differentiated HCC manifesting hyperattenuation on both CT during arteriography and arterial portography

Figure 1 Ultrasound (US) image of a 20-mm hypoechoic nodule in segment 2 (S2).

Figure 2 Contrast enhanced US of the nodule in S2. A: Hypervascularity in the early vascular phase; B: Defect in the post-vascular phase.

Figure 3 A: Hyperattenuation in S2 on computed tomography during arteriography (CTA); B: Hyperattenuation in S2 on computed tomography during arterial portography (CTAP).

Figure 4 Histological features of a US-guided biopsy of a hyperechoic nodule in S2. A: Well- to moderately-differentiated HCC characterized by more than two-fold the cellularity of the non-tumorous area, fatty change, clear cell change and mild cell atypia with a thin to mid-trabecular pattern (HE×100); B: Immunohistochemical finding, HSP70 partly positive HCC cells; C: Immunohistochemical finding, CAP2 strongly positive HCC cells; D: Immunohistochemical staining of CD34 in the sinusoidal blood space is positive, showing capillarization; E: Immunohistochemical staining of CD68 Kupffer cells in the sinusoidal blood space is relatively less positive; F: Non-HCC area of immunohistochemical staining of CD68 Kupffer cells in the sinusoidal blood space.