fig6

Figure 6. Metastasis of hepatocellular carcinoma to the lung in June 2018. The axial postcontrast chest CT image (A) shows the 1.2 cm right lower lobe nodular lesion (arrow). The axial image more superiorly shows additional nodular lesions (arrows), patchy airspace opacity (arrowheads) representing radiation treatment changes targeted to the previously noted left upper lobe mass (dashed arrow); H&E stain (400x) of tissue from the right lower lobe lesion obtained by CT-guided core needle biopsy (C), which reveals metastatic hepatocellular carcinoma displaying a dissimilar morphology to the primary lung adenocarcinoma with relatively small and monotonous nuclei; Mucin production is also absent. Immunohistochemical stain for hepatocyte specific antigen (Hep Par-1) of the same tissue from the right lower lobe (D) shows strong positivity in tumor cells, further supporting hepatocellular origin