Secondary hepatic involvement with lymphoma

Große
hypodense Raumforderungen in Leber und Milz, die sich in einer Biopsie der Leber als blastäres Non-Hodgkin-Lymphom der B-Zell-Reihe herausstellten. Computertomographie axial und coronar.
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Spectrum of
imaging findings in AIDS-related diffuse large B cell lymphoma. Axial CT images axial contrast-enhanced CT image and liver ultrasound of a patient with HIV-associated primary hepatic lymphoma. The contrast-enhanced CT shows a homogeneous soft tissue attenuation mass which does not show significant enhancement, and with fear preservation of the surrounding liver architecture. The mass displaces or encases the hepatic veins but does not invade vasculature or lead to tumor thrombus. On ultrasound, it appears as a fairly homogenous mass hypoechoic to the liver parenchyma. There is no increase vascularity within the mass or in its periphery
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Spectrum of
imaging findings in AIDS-related diffuse large B cell lymphoma. Coronal and axial CECT images of the abdomen (a and b) show hepatomegaly and a heterogenous hypoattenuating mass infiltrating through most of the right lobe of the liver. The infiltrative liver mass had more focal hypoattenuating areas (fat arrow). Aortocaval lymph nodes are also noted (short arrow). Axial CT through the pelvis in bone window (c) shows a permeative process involving the left femoral head and neck and associated pathological fracture
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Secondary hepatic involvement with lymphoma (secondary hepatic lymphoma) is common, much more so than primary hepatic lymphoma.

Clinical presentation

Hepatomegaly with deranged liver function tests is the most common presentation. Jaundice is common. Rarely, patients may present with acute liver failure .

Pathology

Hepatic involvement is more common at presentation in non-Hodgkin lymphoma (~20% of cases) than in Hodgkin lymphoma (~5% of cases) .

Radiographic features

Secondary hepatic lymphoma is typically diffusely infiltrating rather than a focal mass. It may sometimes have a miliary/nodular pattern.

Ultrasound

The liver is normal in ~25% of cases and features of secondary hepatic lymphoma are non-specific :

  • well-defined small nodular hypoechoic lesions
    • occasionally may be a "target lesion"
  • diffuse infiltrative disease
  • hepatomegaly (30%)
  • abdominal lymphadenopathy
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu secondary hepatic lymphoma:
primary
hepatic lymphoma
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