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

Abstract

Imaging findings of hepatic lymphoma of mucosa-associated lymphoid tissue (MALT) have been rarely reported before. We present the computed tomography (CT), magnetic resonance imaging (MRI), and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in a patient with untreated pulmonary and hepatic MALT lymphoma over a 5-year period.On the 1st abdominal MRI scan, the hepatic MALT lymphoma showed multiple hepatic subcapsular masses. On FDG PET/CT, these hepatic tumors showed hypodenisty with FDG uptake similar to the liver on early PET images, and higher than liver on delayed PET images. The patient declined to undergo treatment. Fiver year later, the follow-up MRI and FDG PET/CT showed enlargement and confluence of the hepatic tumors with higher FDG uptake than before. The enlarged hepatic tumors had minimal mass effect. In the hepatic lesions, the blood vessels and bile ducts had no distortion or displacement.The hepatic MALT lymphoma should be taken into consideration when the hepatic tumors have minimal mass effect with the intrahepatic blood vessels and bile ducts normally passing through the tumors. Delayed-time-point FDG PET/CT imaging may be helpful for improving detectability of the hepatic MALT lymphoma.

Role of Surveillance CT in Detection of Pre-Clinical Relapse in Patients with B-Cell Lymphoma : A Retrospective Study

“…The low median number of routine imaging studies performed in the current study population of relapse patients does not reflect a restrictive use of surveillance imaging or non-adherence to local protocols, but rather the fact that relapse mainly occurs early in the follow-up period and sometimes before the first surveillance imaging (13) .…”

A Case of Primary Hepatic Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue (MALT) type Treated by Radiofrequency Ablation (RFA) and Literature Review.

“…Dong et al consider that when liver tumors have no obvious space-occupying effect in CT imaging, and the blood vessels and bile ducts in the liver are running normally, the possibility of hepatic MALT lymphoma should not be excluded. 20 In our literature review, there are 35 more complete MRI descriptions. Almost all cases showed T1 low signal and T2 high signal, but there was no regular performance in the arterial and portal phase.…”

“…84 In previous reports, 17 cases of PET-CT were performed, and their hepatic MALT lymphomas all showed high metabolism of 18F-FDG. 7,9,11,17,19,20,29,34,49,61,69,75 A recent study proposed that the 18-FDG metabolic rate of extragastric MALT lymphoma is signi cantly related to Ki-67 proliferation. 85 When Ki-67>15%, the 18-FDG intake of the lesions was signi cantly increased, but only 4 cases of related hepatic MALT lymphoma cases were involved.…”

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

“…Lymphomas of MALT are low-grade extranodal marginal zone B-cell lymphoma [ 1 ] (accounting for approximately 8% of all NHL). [ 2 , 3 ] MALT lymphomas originate from cells which can differentiate into edged monocyte-like B cells and cells near the plasma germinal center, which is one of the most common extranodal low-grade malignant lymphoma. They commonly occur in the gastrointestinal tract such as stomach, and nongastrointestinal sites like salivary glands, thyroid, and lungs.…”

“…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.…”