Abstract
Purpose
Imaging manifestations of hepatic lymphoma, both primary (PHL) and secondary (SHL), are extremely variable and non-specific, but some features are useful diagnostic clues in an appropriate clinical setting. Through a PubMed search, we found several published reviews focused on PHL and SHL diagnosis. However, to the best of our knowledge, few of them encompass a comprehensive analysis of all the diagnostic tools and relative radiological findings. The aim of this review is to provide a description of the radiological features of both PHL and SHL, by critically analyzing the available literature.
Materials and methods
An extensive review of published literature along with a description of personal case series of both PHL and SHL has been conducted.
Results
SHL can be easily diagnosed with imaging techniques, as it is usually associated with node disease. On the contrary the diagnosis can be a challenge in PHL, often mimicking HCC or liver metastasis of adenocarcinoma. In this context, multiparametric MRI plays a fundamental role in the differential diagnosis. Both for PHL and SHL, liver involvement presents as solitary or multiple lesions or as diffuse infiltrative disease.
Conclusion
PHL and SHL may be correctly characterized using different radiological techniques. Both CT and MRI have showed a good correlation with histology, as they permit to distinguish between lymphomatous tissue, and necrotic and fibrotic areas.
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Abbreviations
- ADC:
-
Apparent diffusion coefficient
- CEA:
-
Carcinoembryonic antigen
- CT:
-
Computed tomography
- DWI:
-
Diffusion-weighted imaging
- FDG:
-
Fluoro deoxy glucose
- Gd-BOPTA:
-
Gadobenate dimeglumine (Multihance®)
- Gd-EOB-DTPA:
-
Gadolinium ethoxybenzyl diethylenetriamine pentacetic acid (Primovist®)
- HCV:
-
Hepatitis C virus
- HCC:
-
Hepatocellular carcinoma
- HL:
-
Hodgkin lymphoma
- MRI:
-
Magnetic resonance imaging
- NHL:
-
Non-Hodgkin lymphoma
- PET:
-
Positron emission tomography
- PHL:
-
Primary hepatic lymphoma
- PTLD:
-
Post-transplant lymphoproliferative disease
- SHL:
-
Secondary hepatic lymphoma
- US:
-
Ultra-sonography
- αFP:
-
αFeto-protein
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Ippolito, D., Porta, M., Maino, C. et al. Diagnostic approach in hepatic lymphoma: radiological imaging findings and literature review. J Cancer Res Clin Oncol 146, 1545–1558 (2020). https://doi.org/10.1007/s00432-020-03205-x
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DOI: https://doi.org/10.1007/s00432-020-03205-x