Imaging of primary non-Hodgkin's lymphoma of the liver.
OBJECTIVE
To describe the radiological findings in primary liver lymphoma, which is a rare entity, presenting usually as a localized liver mass.


METHODS
We reviewed retrospectively the imaging findings at presentation, of patients in whom a diagnosis of primary liver lymphoma was finally made histologically. The study period covered a 10-year period between January 1990 and December 1999. There were seven patients, all men, with a mean age of 49.6 years. Each patient presented with hepatobiliary disease without peripheral adenopathy. Imaging prior to diagnosis included ultrasonography (seven patients), computed tomography (seven patients) and magnetic resonance imaging (MRI) (two patients). Appearances during and after aggressive chemotherapy were reviewed.


RESULTS
Imaging appearances were of either single or multiple liver lesions simulating liver metastases. On ultrasound all foci of primary hepatic lymphoma (PHL) were hypoechoic relative to normal liver. Computed tomography (CT) showed hypoattenuating lesions in all cases, and two cases showed rim enhancement following contrast administration. The MRI appearances were variable, and no pathognomonic feature of PHL was identified, so that histology was required in all patients to establish the diagnosis.


CONCLUSIONS
This paper demonstrates the spectrum of findings encountered on various imaging modalities in PHL. We conclude that although PHL is a rare condition, it should always be considered in the differential diagnosis of liver metastases when no primary tumour is apparent.
Maher
M M
MM
Departments of Radiology, Oncology and Pathology, Mater Misericordiae Hospital, Eccles St, Dublin 7, Ireland. mickndoc@aol.com
McDermott
S R
SR
Fenlon
H M
HM
Conroy
D
D
O'Keane
J C
JC
Carney
D N
DN
Stack
J P
JP
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
D003287:Contrast Media