Primary hepatic lymphoma - diffuse large B-cell lymphoma (DLBCL)
Presentation
Epigastric pain with a palpable mass.
Patient Data
Large well-circumscribed lobulated hepatic mass centered on the left lobe. It elicits a low signal on T1, a moderate to high signal on T2 and T2 fat sat with restricted diffusion, the ADC value within the tumor was 44 % compared to the normal liver. The postcontrast sequences show moderate heterogeneous enhancement (hypoenhancing relative to the liver on all phases) with central necrosis and peripheral rim enhancement.
No abdominal lymphadenopathy or peritoneal effusion.
Case Discussion
MRI features of a large lobulated hypoenhancing hepatic mass with very low ADC.
The patient underwent an ultrasound-guided biopsy, that confirms the diagnosis of a primary hepatic lymphoma (diffuse large B-cell lymphoma (DLBCL) in this case).
Primary hepatic lymphoma (PHL) is very rare, with approximately 100 described cases in the literature and accounts for <1% of all non-Hodgkin lymphomas.
it is primarily found in immunocompromised patients due to AIDS/HIV, congenital immunodeficiency, collagen vascular disease, and immunosuppressant therapy for organ transplant.
Diffuse large B-cell lymphoma is the most common histological subtype. Other histologic subtypes include:
peripheral T-cell leukemia/lymphoma
Additional contributor: Dr. D Merazga, MD, Mezdaouet Clinic, Khenchela, Algeria
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