Primary hepatic lymphoma: Imaging findings

Elsayes, Khaled M.; Menias, Christine O.; Willatt, Jonathon M.; Pandya, Abhilash; Wiggins, Michele L.

doi:10.1111/j.1754-9485.2009.02081.x

Cited by 38 publications

(25 citation statements)

References 22 publications

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“…Lack of deterministic findings for US and CEUS has been thought to be the reason why only a small number of patients have been reported with an HML. In general, an HML is revealed as a homogeneous hypo-echoic lesion [1][2][3] , and often includes the portal vein or hepatic vein inside of the tumor without invasion (penetrating sign) in conventional US findings [4,5] . Based on the present results, image findings of HML might differ depending on the tumor diameter.…”

Section: Discussionmentioning

confidence: 99%

“…Evaluations of abdominal ultrasonography (US) findings of primary and secondary tumor-forming hepatic ML (HML) tumors have not been adequately reported. It is generally considered that an HML is revealed as a homogeneous hypo-echoic lesion [1][2][3] that often includes a portal or hepatic vein inside of the tumor without invasion (penetrating sign) [4,5] in conventional US findings. However, a small number of patients with HML shows that there is a lack of deterministic findings in US and contrast-enhanced US (CEUS) examinations.…”

Section: Abdominal Ultrasound Findings Of Tumor-forming Hepatic Maligmentioning

confidence: 99%

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Abdominal Ultrasound Findings of Tumor-Forming Hepatic Malignant Lymphoma

Kitahata

Hiraoka²,

Kudo³

et al. 2017

Dig Dis

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Aim/Background: Evaluations of abdominal ultrasonography (US) findings of primary and secondary tumor-forming hepatic malignant lymphoma (HML) have not been adequately reported. In this study, we elucidated US and contrast-enhanced US (CEUS) findings in patients with HML. Materials/Methods: From January 2006 to March 2017, 25 patients with HML were enrolled (primary 7, secondary 18), each of whom was diagnosed pathologically. They were divided into 2 groups based on tumor diameter (cutoff, 30 mm). US imaging findings were retrospectively analyzed. Results: All tumors in patients with a small HML (<30 mm in diameter, small group, n = 14) were revealed as homogeneous hypo-echoic type (100%), with penetrating sign observed in only 1 patient. Tumors in 11 patients in the small group, examined with CEUS, showed homogeneous enhancement in the early vascular phase (91%) and a washout pattern in the portal phase (100%), and they were revealed as defective in the post-vascular phase (100%). In the large group (≥30 mm; n = 11), tumors were revealed as a heterogeneous hypo-echoic lesion in 10 (91%) and penetrating sign was observed in 8 (73%). Dilatation of the distal intrahepatic bile duct by the tumor was observed in 4 patients in the large group. In 7 large group patients examined with CEUS, imaging findings in the early vascular phase varied, with 5 (71%) showing a washout pattern in the portal phase and 5 (71%) revealed as defective in the post-vascular phase. Conclusion: We found that US imaging features of HML differ depending on the tumor diameter.

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Section: Discussionmentioning

confidence: 99%

Section: Abdominal Ultrasound Findings Of Tumor-forming Hepatic Maligmentioning

confidence: 99%

Abdominal Ultrasound Findings of Tumor-Forming Hepatic Malignant Lymphoma

Kitahata

Hiraoka²,

Kudo³

et al. 2017

Dig Dis

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“…The most common manifestation is a solitary lesion, and the diffuse infiltration is rare and indicates a worse prognosis. The imaging appearance of hepatic lymphoma is non-specific and, on ultrasound, the lesions usually appear hypoechoic with no typical vascularization pattern (3,17). PHL lesions appear as hypoattenuating in CT scans, which may have a low-intensity central area with no enhancement following the administration of an intravenous contrast in half the cases, patchy enhancement in 33% of patients and a ring of enhancement in ~25% of cases (3,17,18).…”

Section: Discussionmentioning

confidence: 99%

“…The imaging appearance of hepatic lymphoma is non-specific and, on ultrasound, the lesions usually appear hypoechoic with no typical vascularization pattern (3,17). PHL lesions appear as hypoattenuating in CT scans, which may have a low-intensity central area with no enhancement following the administration of an intravenous contrast in half the cases, patchy enhancement in 33% of patients and a ring of enhancement in ~25% of cases (3,17,18). Classically, MRI findings in PHL are described as ‘hypointense’ or ‘isointense’ on T1WI, and ‘hyperintense’ on T2WI (3,19).…”

Section: Discussionmentioning

confidence: 99%

Primary hepatic peripheral T-cell lymphoma: A case report

Liao

2014

Oncology Letters

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Primary hepatic peripheral T-cell lymphoma (PHL) is extremely rare. A case of primary hepatic peripheral T-cell lymphoma of a 59-year-old male is presented in the current study. PHL lesions are diagnosed by the existence of a hepatic mass, in the absence of lymphadenopathy, splenomegaly or bone marrow involvement associated with normal tumor markers. Treatment options are surgical resection and subsequent chemotherapy. Histopathological examination by immunohistochemical staining of the tissue biopsies at laparotomy confirmed a diagnosis of PHL.

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“…Some mild perilesional enhancement in delayed images, after administration of intravenous contrast, can also be observed. These MRI findings can be helpful for the radiologists to suspect a PHL [23]. Relevant studies also mention that 18FDG PET/CT can further assist to a PHL's diagnosis by demonstrating the absence of pathologically hypermetabolic foci in any other nodes or organs, when CT scan alone is inadequate to differentiate PHL and secondary liver lymphoma [24].…”

Section: Diagnostic Approachmentioning

confidence: 99%

Primary Hepatic Lymphoma: Dilemmas in Diagnostic Approach and Therapeutic Management

Mastoraki¹,

Stefanou²,

Chatzoglou³

et al. 2013

Indian J Hematol Blood Transfus

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Primary hepatic lymphoma (PHL) is a very rare malignancy and is characterized by liver involvement at presentation with no affectation of the spleen, lymph nodes, peripheral blood, bone marrow, or other tissues until at least 6 months after diagnosis. PHL should be considered in the differential diagnosis in a patient with space-occupying liver lesions and normal levels of alpha-fetoprotein and CEA. A computed tomography (CT) scan is the commonly used modality for staging lymphomas. The widespread use of positron emission tomography/ CT results in the improvement in the accuracy of detecting the extent of disease, response evaluation, and prognostication. The liver biopsy, due to its pleomorphic appearances in the needle biopsy specimen, can be very challenging. Current literature favors the combination of chemotherapy as the frontline treatment for its least invasiveness and improved survival. Favorable prognosis of PHL can be obtained by early surgery combined with chemotherapy in strictly selected patients. However, the optimal therapy is still unclear and the outcomes are uncertain.

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Primary hepatic lymphoma: Imaging findings

Abstract: Primary hepatic lymphoma (PHL) is rare, accounting for less than 1% of all extranodal lymphomas. In this article, we retrospectively reviewed the imaging features of 12 pathologically proven cases of primary hepatic lymphoma.

Cited by 38 publications

References 22 publications

Abdominal Ultrasound Findings of Tumor-Forming Hepatic Malignant Lymphoma

Abdominal Ultrasound Findings of Tumor-Forming Hepatic Malignant Lymphoma

Primary hepatic peripheral T-cell lymphoma: A case report

Primary Hepatic Lymphoma: Dilemmas in Diagnostic Approach and Therapeutic Management

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