Case study: Imaging signs and differential diagnosis of diffuse-type primary hepatic lymphoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Aoxiang , ZHAO Youjin , CHEN Weixia ,  LU Chunyan

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LU Chunyan, Email: luchunyan@wchscu.cn

Keywords：

liver; primary lymphoma; imaging signs; pathological basis; differential diagnosis

DOI：

10.7507/1007-9424.202408090

Video：

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Lymphoma originating in the liver was rare and few clinical cases had been reported. The imaging manifestations of primary hepatic lymphoma (PHL) were lack of specificity and diverse. The authors displayed the CT and MRI images of 1 patient with diffuse infiltration of PHL and made a brief description of imaging features, underlying pathophysiological mechanisms, and differential diagnoses of PHL, with the hope of strengthening the understanding of PHL for clinicians and radiologists.

1.	Pérez-Turrent MA, Hernández-Solís JI, Sánchez Antonio EE, et al. Hepatic diffuse large B-cell lymphoma: a case report and review of literature of primary liver tumors. Cureus, 2024, 16(2): e54947. doi: 10.7759/cureus.54947.
2.	Taiji R, Marugami N, Marugami A, et al. Multimodality imaging of primary hepatic lymphoma: A case report and a literature review. Diagnostics (Basel), 2024, 14(3): 306. doi: 10.3390/diagnostics14030306.
3.	Abe H, Kamimura K, Kawai H, et al. Diagnostic imaging of hepatic lymphoma. Clin Res Hepatol Gastroenterol, 2015, 39(4): 435-442.
4.	Jiang M, Jiang S, Yang Y, et al. Primary hepatic lymphoma a case report and literature review. Medicine (Baltimore), 2023, 102(50): e36688. doi: 10.1097/MD.0000000000036688.
5.	Tung RT, Heyns J. Primary hepatic lymphoma: A rare form of diffuse large B-cell lymphoma of the liver. Fed Pract, 2023, 40(Suppl 1): S40-S44. doi: 10.12788/fp.0365.
6.	Freitas BD, Salgadinho Machado A, Lagarto M, et al. Nodular lymphocyte-predominant hodgkin lymphoma: a rare lymphoma with isolated hepatic presentation. Eur J Case Rep Intern Med, 2023, 10(11): 004061. doi: 10.12890/2023_004061.
7.	Pan B, Wang CS, Han JK, et al. ¹⁸F-fluorodeoxyglucose PET/CT findings of a solitary primary hepatic lymphoma: a case report. World J Gastroenterol, 2012, 18(48): 7409-7412.
8.	Kaneko K, Nishie A, Arima F, et al. A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma. Ann Nucl Med, 2011, 25(4): 303-307.
9.	Ippolito D, Porta M, Maino C, et al. Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review. J Cancer Res Clin Oncol, 2020, 146(6): 1545-1558.
10.	吴应行, 杨真露, 张道恩, 等. 7例肝脏原发性淋巴瘤的MSCT表现. 临床放射学杂志, 2019, 38(9): 1667-1670.
11.	Emile JF, Azoulay D, Gornet JM, et al. Primary non-Hodgkin's lymphomas of the liver with nodular and diffuse infiltration patterns have different prognoses. Ann Oncol, 2001, 12(7): 1005-1010.
12.	Mastoraki A, Stefanou MI, Chatzoglou E, et al. Primary hepatic lymphoma: dilemmas in diagnostic approach and therapeutic management. Indian J Hematol Blood Transfus, 2014, 30(3): 150-154.
13.	Mamone G, Di Piazza A, Carollo V, et al. Imaging of primary malignant tumors in non-cirrhotic liver. Diagn Interv Imaging, 2020, 101(9): 519-535.
14.	陆蓉, 周建军, 周康荣, 等. 肝脏继发淋巴瘤CT表现与病理的对照分析. 中华放射学杂志, 2009, 43(4): 382-385.
15.	Maher MM, McDermott SR, Fenlon HM, et al. Imaging of primary non-Hodgkin’s lymphoma of the liver. Clin Radiol, 2001, 56(4): 295-301.
16.	Higuma Y, Yamauchi R, Fujimitsu R, et al. Hepatic Hodgkin lymphoma with delayed enhancement on CT and MRI. Radiol Case Rep, 2016, 12(1): 45-49.
17.	Colagrande S, Calistri L, Grazzini G, et al. MRI features of primary hepatic lymphoma. Abdom Radiol (NY), 2018, 43(9): 2277-2287.
18.	Lee J, Park KS, Kang MH, et al. Primary hepatic peripheral T-cell lymphoma mimicking hepatocellular carcinoma: a case report. Ann Surg Treat Res, 2017, 93(2): 110-114.
19.	Rajesh S, Bansal K, Sureka B, et al. The imaging conundrum of hepatic lymphoma revisited. Insights Imaging, 2015, 6(6): 679-692.
20.	陈榆舒, 秦韵, 陈卫霞, 等. 肝血管平滑肌脂肪瘤—“快进快出”但非肝细胞癌. 中国普外基础与临床杂志, 2023, 30(3): 285-289.
21.	Pickhardt PJ, Kitchin D, Lubner MG, et al. Primary hepatic angiosarcoma: multi-institutional comprehensive cancer centre review of multiphasic CT and MR imaging in 35 patients. Eur Radiol, 2015, 25(2): 315-322.
22.	Ha FS, Liu H, Han T, et al. Primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome: A case report. World J Gastrointest Oncol, 2022, 14(5): 1050-1056.
23.	赵紫园, 赵又瑾, 陈卫霞, 等. 病例分析: 肝窦阻塞综合征的影像学征象. 中国普外基础与临床杂志, 2024, 31(5): 571-574.
24.	Cakir B, Teksam M, Tarhan NC et al. Unusual MDCT and sonography findings in fulminant hepatic failure resulting from hepatitis A infection. AJR Am J Roentgenol, 2005, 185(4): 1033-1035.
25.	陈枫, 赵大伟, 李宏军, 等. 急性病毒性肝炎的CT及MRI表现. 放射学实践, 2014, 29(8): 965-969.
26.	Lee JA, Jeong WK, Min JH, et al. Primary hepatic lymphoma mimicking acute hepatitis. Clin Mol Hepatol, 2013, 19(3): 320-323.
27.	Ch’ng LS, Amzar H, Ghazali KC, et al. Imaging appearances of hepatic tuberculosis: experience with 12 patients. Clin Radiol, 2018, 73(3): 321. e11-321. e16. doi: 10.1016/j.crad.2017.10.016.
28.	Masuda K, Takenaga S, Morikawa K, et al. Hepatic sarcoidosis with atypical radiological manifestations: A case report. Radiol Case Rep, 2018, 13(5): 936-939.
29.	Boll DT, Merkle EM. Diffuse liver disease: strategies for hepatic CT and MR imaging. Radiographics, 2009, 29(6): 1591-1614.

1. Pérez-Turrent MA, Hernández-Solís JI, Sánchez Antonio EE, et al. Hepatic diffuse large B-cell lymphoma: a case report and review of literature of primary liver tumors. Cureus, 2024, 16(2): e54947. doi: 10.7759/cureus.54947.
2. Taiji R, Marugami N, Marugami A, et al. Multimodality imaging of primary hepatic lymphoma: A case report and a literature review. Diagnostics (Basel), 2024, 14(3): 306. doi: 10.3390/diagnostics14030306.
3. Abe H, Kamimura K, Kawai H, et al. Diagnostic imaging of hepatic lymphoma. Clin Res Hepatol Gastroenterol, 2015, 39(4): 435-442.
4. Jiang M, Jiang S, Yang Y, et al. Primary hepatic lymphoma a case report and literature review. Medicine (Baltimore), 2023, 102(50): e36688. doi: 10.1097/MD.0000000000036688.
5. Tung RT, Heyns J. Primary hepatic lymphoma: A rare form of diffuse large B-cell lymphoma of the liver. Fed Pract, 2023, 40(Suppl 1): S40-S44. doi: 10.12788/fp.0365.
6. Freitas BD, Salgadinho Machado A, Lagarto M, et al. Nodular lymphocyte-predominant hodgkin lymphoma: a rare lymphoma with isolated hepatic presentation. Eur J Case Rep Intern Med, 2023, 10(11): 004061. doi: 10.12890/2023_004061.
7. Pan B, Wang CS, Han JK, et al. ¹⁸F-fluorodeoxyglucose PET/CT findings of a solitary primary hepatic lymphoma: a case report. World J Gastroenterol, 2012, 18(48): 7409-7412.
8. Kaneko K, Nishie A, Arima F, et al. A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma. Ann Nucl Med, 2011, 25(4): 303-307.
9. Ippolito D, Porta M, Maino C, et al. Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review. J Cancer Res Clin Oncol, 2020, 146(6): 1545-1558.
10. 吴应行, 杨真露, 张道恩, 等. 7例肝脏原发性淋巴瘤的MSCT表现. 临床放射学杂志, 2019, 38(9): 1667-1670.
11. Emile JF, Azoulay D, Gornet JM, et al. Primary non-Hodgkin's lymphomas of the liver with nodular and diffuse infiltration patterns have different prognoses. Ann Oncol, 2001, 12(7): 1005-1010.
12. Mastoraki A, Stefanou MI, Chatzoglou E, et al. Primary hepatic lymphoma: dilemmas in diagnostic approach and therapeutic management. Indian J Hematol Blood Transfus, 2014, 30(3): 150-154.
13. Mamone G, Di Piazza A, Carollo V, et al. Imaging of primary malignant tumors in non-cirrhotic liver. Diagn Interv Imaging, 2020, 101(9): 519-535.
14. 陆蓉, 周建军, 周康荣, 等. 肝脏继发淋巴瘤CT表现与病理的对照分析. 中华放射学杂志, 2009, 43(4): 382-385.
15. Maher MM, McDermott SR, Fenlon HM, et al. Imaging of primary non-Hodgkin’s lymphoma of the liver. Clin Radiol, 2001, 56(4): 295-301.
16. Higuma Y, Yamauchi R, Fujimitsu R, et al. Hepatic Hodgkin lymphoma with delayed enhancement on CT and MRI. Radiol Case Rep, 2016, 12(1): 45-49.
17. Colagrande S, Calistri L, Grazzini G, et al. MRI features of primary hepatic lymphoma. Abdom Radiol (NY), 2018, 43(9): 2277-2287.
18. Lee J, Park KS, Kang MH, et al. Primary hepatic peripheral T-cell lymphoma mimicking hepatocellular carcinoma: a case report. Ann Surg Treat Res, 2017, 93(2): 110-114.
19. Rajesh S, Bansal K, Sureka B, et al. The imaging conundrum of hepatic lymphoma revisited. Insights Imaging, 2015, 6(6): 679-692.
20. 陈榆舒, 秦韵, 陈卫霞, 等. 肝血管平滑肌脂肪瘤—“快进快出”但非肝细胞癌. 中国普外基础与临床杂志, 2023, 30(3): 285-289.
21. Pickhardt PJ, Kitchin D, Lubner MG, et al. Primary hepatic angiosarcoma: multi-institutional comprehensive cancer centre review of multiphasic CT and MR imaging in 35 patients. Eur Radiol, 2015, 25(2): 315-322.
22. Ha FS, Liu H, Han T, et al. Primary hepatic angiosarcoma manifesting as hepatic sinusoidal obstruction syndrome: A case report. World J Gastrointest Oncol, 2022, 14(5): 1050-1056.
23. 赵紫园, 赵又瑾, 陈卫霞, 等. 病例分析: 肝窦阻塞综合征的影像学征象. 中国普外基础与临床杂志, 2024, 31(5): 571-574.
24. Cakir B, Teksam M, Tarhan NC et al. Unusual MDCT and sonography findings in fulminant hepatic failure resulting from hepatitis A infection. AJR Am J Roentgenol, 2005, 185(4): 1033-1035.
25. 陈枫, 赵大伟, 李宏军, 等. 急性病毒性肝炎的CT及MRI表现. 放射学实践, 2014, 29(8): 965-969.
26. Lee JA, Jeong WK, Min JH, et al. Primary hepatic lymphoma mimicking acute hepatitis. Clin Mol Hepatol, 2013, 19(3): 320-323.
27. Ch’ng LS, Amzar H, Ghazali KC, et al. Imaging appearances of hepatic tuberculosis: experience with 12 patients. Clin Radiol, 2018, 73(3): 321. e11-321. e16. doi: 10.1016/j.crad.2017.10.016.
28. Masuda K, Takenaga S, Morikawa K, et al. Hepatic sarcoidosis with atypical radiological manifestations: A case report. Radiol Case Rep, 2018, 13(5): 936-939.
29. Boll DT, Merkle EM. Diffuse liver disease: strategies for hepatic CT and MR imaging. Radiographics, 2009, 29(6): 1591-1614.

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