Primary MALT-Lymphoma of the Liver: Multimodality Imaging

Abstract

MALT lymphoma rarely affects the liver. We present a case of primary MALT lymphoma of the liver, which appeared as multifocal hyperattenuated lesions compared to the fatty liver on unenhanced CT and as moderately hyperintense on T2-weighted and hypointense on T1-weighted MRI. We describe the radiological imaging features and discuss the differential diagnosis.

Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type

“…[22,24] Meanwhile, distinctive radiological features were absent. Ultrasound studies showed majority of the hepatic MALT lymphomas as hypoechoic masses, [7,15,16,22,26,29,31,40,43] which was in agreement with a previous study of liver lymphomas. [51] On contrast-enhanced CT, primary hepatic MALT lymphoma had been described as low-density mass, which was not enhanced, [16,17,31,39] or faint enhanced, [15,36,40] or enhanced peripherally in the early arterial phase.…”

“…Ultrasound studies showed majority of the hepatic MALT lymphomas as hypoechoic masses, [7,15,16,22,26,29,31,40,43] which was in agreement with a previous study of liver lymphomas. [51] On contrast-enhanced CT, primary hepatic MALT lymphoma had been described as low-density mass, which was not enhanced, [16,17,31,39] or faint enhanced, [15,36,40] or enhanced peripherally in the early arterial phase. [29] MRI was characterized by low signal intensity on T1-weighted images and moderately high signal intensity on T2-weighted images, and the enhancement pattern was similar to that of CT. [15,22,35,36,40,43] Our case also had these radiological features.…”

“…[51] On contrast-enhanced CT, primary hepatic MALT lymphoma had been described as low-density mass, which was not enhanced, [16,17,31,39] or faint enhanced, [15,36,40] or enhanced peripherally in the early arterial phase. [29] MRI was characterized by low signal intensity on T1-weighted images and moderately high signal intensity on T2-weighted images, and the enhancement pattern was similar to that of CT. [15,22,35,36,40,43] Our case also had these radiological features. Accordingly, the imaging features were similar to that of hepatocellular carcinoma, intrahepatic cholangiocellular carcinoma, or metastatic tumor, so the diagnosis was commonly misjudged.…”

Primary hepatic extranodal marginal zone B-cell lymphoma treated by surgical resection: A case report

“…3,8 Literature MRI findings of primary hepatic MALT lymphoma are similar to those in our case, including hypointensity on T1-weighted images, moderate hyperintensity on T2-weighted images, and a slight and peripheral enhancement pattern. 9 Therefore, in most cases, the preoperative diagnosis was non-specific, prompting biopsy (8,9) or surgery if there was suspicion of cholangiocellular carcinoma 3,7 or hepatocellular carcinoma. 8 The etiology of hepatic primary lymphoma is not fully understood.…”

Primary hepatic mucosa-associated lymphoid tissue lymphoma and hemangioma with chronic hepatitis B virus infection as an underlying condition

“…There are no positive serum markers, and imaging studies such as MRI, computed tomography, and US do not yield patterns with features specific to hepatic MALT lymphoma (17).…”