Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma

Abstract

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare, and the etiology of disease is not fully understood. We present herein the case of a primary hepatic MALT lymphoma with Helicobacter pylori and hepatitis C virus infection. A 71-year-old male was admitted to our institution to undergo a precise evaluation of a hepatic tumor incidentally detected during a computed tomography (CT) scan for chest examination. Dynamic CT showed faint enhancement during the arterial phase. The gadoxetate disodium-enhanced magnetic resonance imaging showed a hyper-intensity on the arterial phase and low intensity during the late and hepatocyte phases. Liver biopsy specimen showed small to intermediate size atypical lymphocytes with positive CD20 immunohistochemical staining. It was finally diagnosed as primary hepatic MALT lymphoma. FDG-PET/CT showed faintly increased uptake with a maximum standardized uptake value of 4.6, and did not show other pathological uptake. We present the rare case of primary hepatic MALT lymphoma and discussed the etiology of this disease.

Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type

“…Ultrasound studies showed majority of the hepatic MALT lymphomas as hypoechoic masses, [7,15,16,22,26,29,31,40,43] which was in agreement with a previous study of liver lymphomas. [51] On contrast-enhanced CT, primary hepatic MALT lymphoma had been described as low-density mass, which was not enhanced, [16,17,31,39] or faint enhanced, [15,36,40] or enhanced peripherally in the early arterial phase. [29] MRI was characterized by low signal intensity on T1-weighted images and moderately high signal intensity on T2-weighted images, and the enhancement pattern was similar to that of CT. [15,22,35,36,40,43] Our case also had these radiological features.…”

“…[51] On contrast-enhanced CT, primary hepatic MALT lymphoma had been described as low-density mass, which was not enhanced, [16,17,31,39] or faint enhanced, [15,36,40] or enhanced peripherally in the early arterial phase. [29] MRI was characterized by low signal intensity on T1-weighted images and moderately high signal intensity on T2-weighted images, and the enhancement pattern was similar to that of CT. [15,22,35,36,40,43] Our case also had these radiological features. Accordingly, the imaging features were similar to that of hepatocellular carcinoma, intrahepatic cholangiocellular carcinoma, or metastatic tumor, so the diagnosis was commonly misjudged.…”

Prognostic value of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in primary hepatic mucosa-associated lymphoid tissue lymphoma

“…The potential metabolic behavior and the utility of 18 F-FDG PET/CT in primary hepatic lymphoma still remain unknown. We have, in the past, reviewed 9 cases of primary hepatic MALT patients (Table 2 ) [ 2 , 9 , 15 , 20 ] with solitary lesions, and double or multiple lesions (66.7% [6/9] and 33.3% [3/9], respectively). These figures correspond to the report of Doi et al [ 15 – 19 ] on liver MALT lymphoma with solitary lesions being more common (76.2% or 32/42) than double (9.5% or 4/42) and multiple (14.3% or 6/42) ones.…”

“…Albano et al [ 9 , 20 , 23 ] described 5 cases of primary hepatic MALT lymphoma and reported a series of 18 F-FDG PET/CT scans performed to evaluate those patients. They recognized that hepatic MALT lymphomas could be studied with 18 F-FDG PET/CT like other 18 F-FDG-avid lymphomas.…”

CT, MRI, and 18F-FDG PET/CT Findings in Untreated Pulmonary and Hepatic B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT) Over a Five-Year Period

“…17,18 FDG PET/CT may be less useful for the detection of hepatic MALT lymphoma because of relatively higher background activity of the liver. 9,19 We present the changes of CT, MRI, and FDG PET/CT findings in a case with untreated pulmonary and hepatic MALT lymphoma over a 5 years. On the 1st FDG PET/CT scan, the hepatic tumors showed FDG uptake similar to surrounding hepatic parenchyma at early FDG PET images and hypermetabolism at delayed FDG PET images, indicating delayed FDG PET/CT imaging may be more useful for tumor detection.…”