Chronic HCV patient with established cirrhotic liver, currently complicated by multifocal and infiltrative hepatocellular carcinoma (HCC) with portal vein invasion forming tumor thrombus.  

Portal vein thrombus is considered a tumor thrombus, as it shows enhancement on arterial phase, vessel expansion and the indistinction between the thrombus and the tumor itself. Macrovascular invasion is characteristic of HCC with the involvement of the portal vein more common than the hepatic veins. Differentiating bland from tumor thrombus is necessary as they have different management and prognosis.