Hepatic Lymphoma





KEY FACTS


Terminology





  • Neoplasm of lymphoid tissues in liver



Imaging





  • 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




    • Discrete form: Multiple well-defined, hypoechoic masses




      • Hypoechogenicity due to high cellular density and lack of background stroma




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




      • May be indistinguishable from normal liver





  • CECT




    • Solid lesions with poor contrast enhancement



    • Usually homogeneous density and rarely necrotic



    • May have thin rim enhancement



    • Diffuse, infiltrative, low-density areas




Top Differential Diagnoses





  • Metastases



  • Multifocal/diffuse hepatocellular carcinoma (HCC)



  • Liver abscesses



  • Hemangiomas



  • Focal fat infiltration/sparing



  • Hepatic cysts



Clinical Issues





  • Primary hepatic lymphoma is rare



  • Secondary hepatic involvement is more common



Diagnostic Checklist





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



  • Confirmation may require needle biopsy



Scanning Tips





  • 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




Nov 10, 2024 | Posted by in ULTRASONOGRAPHY | Comments Off on Hepatic Lymphoma

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