A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma
- 371 Downloads
Primary hepatic lymphoma (PHL) is a very rare disease, especially in the diffuse type. We report a case of a middle-aged man with hepatitis C virus infection who developed diffuse-type PHL mimicking diffuse hepatocellular carcinoma (HCC). Contrast-enhanced computed tomography (CT) and magnetic resonance imaging showed diffusely infiltrated hypovascular lesions throughout the liver, but no intrahepatic portal venous thrombus was observed. Diffusion-weighted imaging and 18F-FDG positron emission tomography/CT, respectively, showed a very low apparent diffusion coefficient value and high FDG uptake. These findings were more suggestive of diffuse-type PHL than diffuse HCC. Liver biopsy examination confirmed a diagnosis of diffuse large B-cell lymphoma. Systemic staging revealed no evidence of nodal or bone marrow involvement, so PHL was diagnosed. The patient was treated with chemotherapy and achieved complete remission. We suggest that a combination of image modalities may enable differentiation of diffuse-type PHL from diffuse HCC.
KeywordsDiffuse-type primary hepatic lymphoma 18F-FDG-PET/CT Diffusion-weighted MRI Diffuse hepatocellular carcinoma
- 5.Noronha V, Shafi NQ, Obando JA, Kummar S. Primary non-Hodgkin’s lymphoma of the liver. Crit Rev Oncol Hematol. 2005;53:199–207.Google Scholar
- 9.Ho CL, Yu SC, Yeung DW. 11C-acetate PET imaging in hepatocellular carcinoma and other liver masses. J Nucl Med. 2003;44:222–3.Google Scholar
- 11.Heo SH, Jeong YY, Shin SS, Kim JW, Lim HS, Lee JH, et al. Apparent diffusion coefficient value of diffusion-weighted imaging for hepatocellular carcinoma: correlation with the histologic differentiation and the expression of vascular endothelial growth factor. Korean J Radiol. 2010;11:295–303.PubMedCrossRefGoogle Scholar
- 12.Nishie A, Tajima T, Asayama Y, Ishigami K, Kakihara D, Nakayama T, et al. Diagnostic performance of apparent diffusion coefficient for predicting histological grade of hepatocellular carcinoma. Eur J Radiol. doi: 10.1016/j.erad.2010.06.019.
- 13.Nasu K, Kuroki Y, Tsukamoto T, Nakajima H, Mori K, Minami M. Diffusion-weighted imaging of surgically resected hepatocellular carcinoma: imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade. Am J Roentgenol. 2009;193:438–44.CrossRefGoogle Scholar