Which item? My build post lists all the base items. The only two that would be hard to get are the eternal necklace and pet since that requires a lucky roll/drop.
Pvp gear is the easiest to roll since most affixes besides crystal are epic which are easy to max.
Consider even if they were using 2x Eternal HP (Fabled Blade + Unreal Hood)
FHP = 16560
FHP x Bonus = 315195 HP
Set affixes slots (five mentioned + 2 useless mythical set affix on eternal items) = 7 Slots
2x Mythics (on eternal items) = 2 Slots
2x Mythology (fixed on eternal items) = 2 Slots
2x All Sets+ = 2 Slots
Also, it costs all crystal affixes = 6 Slots
To get that flat HP = 7 Slots
1x Balance = 1 Slot
1x Epic Luck = 1 Slot
Total = 28 Slots, Slots Left = 42 - 26 = 14
On these you can still put PLT, Barbarian, ED+ (2x value on eternals), Procs and more things to increases your power.
Although, I must mention that I don’t remember anyone using fabled blade or unreal hood on arena and they still had that values of HP or even more. Maybe I’m missing something on my calcs.
I have a proc based character that uses some of immortal build but no hp or armour. 3000 hp in battle arena (very bad) but can do 250 thousand damage per round if he stays alive