Misdiagnosis of left supraclavicular lymph node metastasis of hepatocellular carcinoma: A case report

Figure 1 Abdominal computed tomographic images before surgery. A: Non-contrast-enhanced computed tomography scan showing the lesion (arrow) located in the right lobe of the liver; B: The lesion (arrow) showed enhancement during the hepatic arterial phase; C: The lesion (arrow) showed no enhancement during the portal phase.

Figure 2 Histopathology of the primary tumor and enlarged left supraclavicular lymph node. A: Cancer cells having oval and single nuclei, with less mitosis and less heteromorphosis in the primary lesion; hematoxylin and eosin (HE) stain, ×400; B: The same changes in cell morphology in left supraclavicular lymph node; HE stain, ×400.

Figure 3 Thoracic computed tomographic and Doppler images after surgery. A: Non-contrast-enhanced computed tomography scan showing enlarged left supraclavicular lymph nodes (arrow), which were easily observed; B: Part of enlarged left supraclavicular lymph nodes (arrow) fused into the mass; C: Enlarged lymph nodes in the mediastinum (arrow) was observed; D and E: Round nodules (arrows) distributed in both lungs; F: A new intrahepatic lesion (arrow) was detected in the non-operating region via Doppler ultrasound.