The findings on the CEUS of diffuse large B cell lymphoma in abdomen: A case report and literature review

Abstract

BackgroundPET-CT is the first choice for the imaging diagnosis of intraperitoneal lymphomas. Contrast-enhanced ultrasound (CEUS) is rare in the diagnosis of intraperitoneal nodal lymphoma.Case summaryA 62-year-old man was admitted for examination with “right upper abdominal pain”. Ultrasound was used to refer to the masses in the hilar region, spleen, and anterior sacral region respectively. The masses were all hypoechoic, and blood flow signals could be detected by CDFI. Laboratory tests of CA125 were within normal limits. CEUS examination was performed on the three masses respectively. The three masses showed different perfusion patterns. Thickened vessels appeared around the mass in the hilar region, a peripheral centrally directed perfusion pattern was observed in the splenic mass, and blood supply vessels appeared in the center of the presacral mass with a significant filling defect. They all showed a contrast pattern with rapid clearance and hypoenhancement compared with the surrounding areas. Ultrasound guided needle biopsy revealed non-Hodgkin’s lymphoma, diffuse large B-cell lymphoma, non-germinal center origin. After biopsy, the patient was treated with R-CHOP regimen for chemotherapy, and the tumor disappeared by routine ultrasound review after 5 cycles of chemotherapy.ConclusionTo the best of our knowledge, this report is the first to describe the findings of CEUS in intraperitoneal nodal lymphoma. CEUS has various manifestations in intraperitoneal nodal lymphoma. Future studies are still needed to explore the diagnostic features of CEUS in intraperitoneal nodal lymphoma.

Cardiac Metastasis in Diffuse Large B Cell Lymphoma: Article Review

“…Multiple therapies including radiation therapy, autologous stem cell transplantation, and chimeric T-cell therapy can be used in addition to chemotherapy. Radiation therapy was performed in 1 case after chemotherapy without significant complications [5]. In our study, three patients underwent CAR-T cell therapy which was associated with cytokine release syndrome but no further cardiotoxicity [10,13].…”

“…Cardiac metastasis develops through three major routes: direct extension of a mediastinal tumor to the heart which usually involves pericardium, retrograde lymphatic spread, and diffuse interstitial-perivascular spread which can lead to an epicardial and myocardial metastasis, respectively. The metastasis can involve all heart structures, most commonly the right atrium [5]. The presentation varies depending on the location, size, and degree of invasion of the tumor, with symptoms including chest pain, dyspnoea, acute heart failure, superior vena cava (SVC) syndrome, embolic phenomenon, and arrhythmia [4].…”

“…The prognosis of cardiac lymphoma is poor due to the progressive nature of the disease and treatment-associated complications. The mortality rate is 8.5% to 25% if left untreated [5]. Early diagnosis and proper treatment can enhance survival rates, and different strategies and adjuvant treatments can be offered [6].…”