Neoplasm of lymphoid tissues in liver

No known specific imaging findings for diagnosis of hepatic lymphoma

Hepatic lymphoma often favors periportal areas due to high content of lymphatic tissue

Grayscale ultrasound

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  Discrete form: Multiple well-defined, hypoechoic masses

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    Hypoechogenicity due to high cellular density and lack of background stroma

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  Infiltrative form: Innumerable subcentimeter hypoechoic foci, miliary in pattern and periportal in location

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    May be indistinguishable from normal liver

CECT

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  Solid lesions with poor contrast enhancement

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  Usually homogeneous density and rarely necrotic

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  May have thin rim enhancement

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  Diffuse, infiltrative, low-density areas

Metastases

Multifocal/diffuse hepatocellular carcinoma (HCC)

Liver abscesses

Hemangiomas

Focal fat infiltration/sparing

Hepatic cysts

Primary hepatic lymphoma is rare

Secondary hepatic involvement is more common

Rule out other multiple liver lesions: Metastasis, HCCs, hepatic cysts, abscesses, hemangiomas

Confirmation may require needle biopsy

Hepatic lymphoma often has pseudocystic appearance; lack of specular reflection of backwall is helpful clue that lesions are not cystic and rather solid markedly hypoechoic masses