The many faces of primary and secondary hepatic lymphoma: imaging manifestations and diagnostic approach

Abstract

Hepatic lymphoma can be divided into its primary and secondary forms. To be classified as primary hepatic lymphoma, the disease should be limited to the liver and hilar lymph nodes, with no distant involvement (to the bone marrow or other sites). Primary hepatic lymphoma is quite rare, accounting for less than 1% of all cases of non-Hodgkin lymphoma, whereas secondary hepatic lymphoma affects nearly half of such cases. Familiarity with the imaging features of hepatic lymphoma is important for its early diagnosis and appropriate management. In this essay, we aim to review the roles of computed tomography and magnetic resonance imaging in identifying and monitoring hepatic lymphomas, using sample cases to describe and illustrate the wide spectrum of imaging findings in the primary and secondary forms of this disorder.

Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil

“…Evaluation of the liver by imaging methods has been the subject of various recent studies in the radiology literature of Brazil (28)(29)(30)(31)(32) . The availability of affordable, good quality ultrasound machines has allowed the development of focused point-of-care ultrasound protocols applicable to tropical diseases.…”

Use of the LI-RADS classification in patients with cirrhosis due to infection with hepatitis B, C, or D, or infected with hepatitis B and D

“…Recent studies in the radiology literature of Brazil have emphasized the importance of imaging examinations in the evaluation of hepatic neoplasms (18)(19)(20)(21)(22)(23) . The present study used the LI-RADS classification system to analyze 38 patients infected with hepatitis viruses (HBV, HCV, HDV, or combinations thereof) who underwent CT. We found that approximately 32% of the patients presented with LI-RADS 5 observations (i.e., lesions diagnosed by imaging as classic HCC).…”

Rare primary hepatic malignancies: A case-based review

“…There are several imaging features of PHL which may help to differentiate it from other more common liver malignancies. First, PHL may present with three distinct morphologic patterns; the most common being a single, well-defined lesion in 64% of cases [48,49]. The other two less common forms include multiple discrete lesions or a diffuse, miliary pattern [48,49].…”

“…First, PHL may present with three distinct morphologic patterns; the most common being a single, well-defined lesion in 64% of cases [48,49]. The other two less common forms include multiple discrete lesions or a diffuse, miliary pattern [48,49]. On ultrasound, PHL most often appears as an homogeneous hypoechoic lesion with well-defined margins [50].…”

“…On contrast enhanced ultrasound, there is washout on late phase [51]. CT demonstrates hypoenhancement in comparison to normal liver parenchyma during both arterial and delayed phases with occasional rim enhancement [48,52]. These lesions rarely contain calcification.…”