Presentation
Loss of weight and abdominal pain.
Patient Data
Large hypoattenuating homogenous well-defined lesion in segment IVa of the liver measuring 5.3 x 6.0 cm. Large soft tissue-density mass in the pancreatic head / neck / body measuring 4.5 x 8.3 cm which surrounds the portal confluence without compression or invasion. No pancreatic or bile duct dilatation. Three small low density splenic lesions. Multiple subtle hypoattenuating regions in both kidneys, most noticeable in the right upper pole posteriorly. Several prominent retroperitoneal lymph nodes are also present.
Case Discussion
The sites of visceral involvement in this case are unusual for most forms of metastatic disease and raise the possibility of non-Hodgkin's lymphoma.
Pathology
Biopsy was consistent with diffuse large B cell lymphoma.