Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review

Ippolito, Davide; Porta, M Della; Maino, Cesare; Pecorelli, Anna; Ragusi, Maria; Giandola, Teresa; Querques, Giulia; Franzesi, Cammillo Talei; Sironi, Sandro

doi:10.1007/s00432-020-03205-x

Cited by 18 publications

(19 citation statements)

References 60 publications

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“…Most cases of hepatic lymphoma are secondary rather than primary to the liver; therefore, CT imaging should demonstrate enlarged lymph nodes and delineate their pathologic extent. However, in patients with NHL ultrasound and CT findings can be unreliable in demonstrating liver involvement [11,12]. This is particularly challenging in patients with a diffuse pattern of liver involvement and nodules less than 1 cm in size who may only have findings of hepatomegaly or no liver findings at all.…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly challenging in patients with a diffuse pattern of liver involvement and nodules less than 1 cm in size who may only have findings of hepatomegaly or no liver findings at all. Further characterization of the malignancy with imaging should involve a combined positron emission tomography/CT (PET/CT), which has been shown to have a sensitivity approaching 100% for splenic involvement of lymphoma and is vital for determining the extranodal extent of disease [11]. Further imaging with MRI is not part of the standard protocol for suspected hepatic lymphomas, but may be considered to further characterize an incidental liver finding in the absence of clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Acute Liver Failure With Severe Lactic Acidosis Secondary to Infiltrative Diffuse Large B-Cell Lymphoma: An Imaging-Negative Presentation

Hafner

Eaton²

2020

Cureus

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Liver involvement by non-Hodgkin's lymphoma is common in late stage disease but rarely results in severe hepatic dysfunction. Here, we discuss a case of acute liver failure (ALF) with severe lactic acidosis in a 75-year-old female with diffuse large B-cell lymphoma (DLBCL). The patient was admitted with nausea, fevers, and mild acidosis. Although radiographic imaging did not demonstrate any liver abnormality, the patient soon developed signs of ALF along with severe lactic acidosis. Despite initiation of chemotherapy, the patient deteriorated quickly and was ultimately put on comfort measures. This case highlights an uncommon manifestation of DLBCL and suggests that an accelerated timeline for beginning chemotherapy may be warranted in patients with high clinical suspicion of secondary hepatic lymphoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute Liver Failure With Severe Lactic Acidosis Secondary to Infiltrative Diffuse Large B-Cell Lymphoma: An Imaging-Negative Presentation

Hafner

Eaton²

2020

Cureus

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“… 1 Though the primary hepatic lymphoma (PHL) is rare, secondary hepatic lymphoma (SHL) is quite common and counts for 20% of non-Hodgkin lymphoma. 2 The treatments of these 2 diseases are different: surgery is the only method to cure ICCA, while chemotherapy plays important role in treating HL. 3 Thus, accurate differentiation of these 2 diseases in the early stage is necessary for choosing appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Intrahepatic Cholangiocarcinoma and Hepatic Lymphoma Based on Radiomics and Machine Learning in Contrast-Enhanced Computer Tomography

Zou

Zhao

et al. 2021

Technol Cancer Res Treat

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Purpose: This study aimed to explore the ability of texture parameters combining with machine learning methods in distinguishing intrahepatic cholangiocarcinoma (ICCA) and hepatic lymphoma (HL). Method: A total of 28 patients with HL and 101 patients with ICCA were included. A total of 45 texture features were extracted by the software LifeX from contrast-enhanced computer tomography (CECT) images and 38 of them were eligible. A total of 5 feature selection methods and 9 feature classification methods were used to build the best diagnostic models, combining with the 10-fold cross-validation to assess the accuracy of these models. The discriminative ability of each model was evaluated by receiver operating characteristic analysis. Result: A total of 45 predictive models were built by the cross combination of each selection and classification method to differentiate ICCA from HL. According to the results of test group, most of the models performed well with a large area under the curve (AUC) (>0.85) and high accuracy (>0.85). Random Forest (RF)_Linear Discriminant Analysis (LDA) (AUC = 0.997, accuracy = 0.969) was the best model among all the 45 models. Conclusion: Combining texture parameters from CECT with multiple machine learning models can differentiate ICCA and HL effectively, and RF_LDA performed the best in this process.

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“…In humans, computed tomography (CT) is performed to diagnose hepatic lymphoma, which is classified as solitary lesion, multiple lesions and diffuse lesions (Maher et al., 2001 ). In hepatic lymphoma, lesions are hypoattenuating on pre‐contrast and have either no contrast enhancement (50%), patchy enhancement (33%) and ring enhancement (16%) (Ippolito et al., 2020 , Maher et al., 2001 ). In dogs, information is limited on the CT findings of the liver for canine hepatic lymphoma.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography may detect liver infiltration of canine diffuse hepatic lymphoma

Tanaka

Yamazaki

Ashida

et al. 2021

Veterinary Medicine & Sci

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Background: In dogs, hepatic lymphoma is characterized by neoplastic lymphocyte infiltration into the liver. Reports on the computed tomography (CT) findings of the liver for canine hepatic lymphoma are few, with only one study of multiple liver lesions type. Objectives:The purpose of this study was to retrospectively assess the CT findings of the liver in canine diffuse hepatic lymphoma. Methods:As control, five dogs without abnormalities in the liver were included. CT data were analysed, and the following were noted: presence of edge bluntness of the liver, presence of periportal collar sign, the liver size:body weight (BW) ratio and the mean attenuation of liver lesions on pre-contrast, arterial-phase, portal-phase and equilibrium-phase post-contrast images.Results: On CT examination, edge bluntness of the liver was significantly detected in lymphoma (4/5, 80%), as opposed to the control (0/5, 0%) (p = 0.048, φ = 0.82). The periportal collar sign was detected in lymphoma (3/5, 60%), as opposed to the control (0/5, 0%) (p = 0.17, φ = 0.65). The liver size:BW ratio of lymphoma cases was significantly higher compared to that of the control cases (p = 0.0002, r = 0.92). The mean Hounsfield unit of lymphoma cases in the pre-contrast, arterial-phase, portalphase and equilibrium-phase images were significantly lower than in the control cases (p = 0.005, r = 0.81; p = 0.0003, r = 0.91; p = 0.01, r = 0.75 and p = 0.02, r = 0.71, respectively).Conclusions: Hepatic lymphoma should be a differential for a blunted and enlarged liver with hypoattenuation on CT examination.

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Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review

Cited by 18 publications

References 60 publications

Acute Liver Failure With Severe Lactic Acidosis Secondary to Infiltrative Diffuse Large B-Cell Lymphoma: An Imaging-Negative Presentation

Acute Liver Failure With Severe Lactic Acidosis Secondary to Infiltrative Diffuse Large B-Cell Lymphoma: An Imaging-Negative Presentation

Differentiation of Intrahepatic Cholangiocarcinoma and Hepatic Lymphoma Based on Radiomics and Machine Learning in Contrast-Enhanced Computer Tomography

Computed tomography may detect liver infiltration of canine diffuse hepatic lymphoma

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