Figure 20.

Combined hepatocellular–cholangiocarcinoma in a 59-year-old woman. In the T2-weighted image (A) a large tumor (arrow) with heterogeneously mildly increased signal intensity is seen in liver segment VII. The tumor (arrow) is hypointense in the plain T1-weighted image (B) with intense rim enhancement on the arterial phase (C), which gradually progresses centrally in the portal venous (D) and delayed phases (E). Hematoxylin and eosin (H&E) staining showed cells of hepatocellular differentiation (dashed arrow) and smaller zones of cholangiocellular differentiation (arrowhead). Normal liver parenchyma is also shown (arrow); original magnification ×40 (F).