title: A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma.
abstract: 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 (18)F-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.
authors.affiliation: PET Imaging Center, Koga Hospital, Kurume, Japan. kkaneko-kyu@umin.ac.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Fumitou
authors.initials: F
authors.lastname: Arima
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Ken
authors.initials: K
authors.lastname: Ono
authors.forename: Junichi
authors.initials: J
authors.lastname: Omagari
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged