Study on the diagnostic value of imaging in primary hepatic lymphoma

doi:10.3877/cma.j.issn.2095-2015.2023.05.015

Abstract

Abstract:

Objective

To summarize the clinical features, CT and MRI imaging findings of primary hepatic lymphoma(PHL), and investigate the diagnostic value of the imaging examination for PHL, so as to provide reliable basis for clinical diagnosis and treatment of PHL.

Methods

A total of 15 patients with PHL confirmed by pathology and complete preoperative imaging data from January 2014 to December 2020 at Third Affiliated Hospital of Naval Medical University were retrospectively analyzed, including 8 cases with CT and 7 cases with MRI.The clinical features and imaging manifestations of PHL were analyzed.

Results

All 15 patients with PHL had no specific clinical manifestations, 11 cases were single lesions and 4 cases were multiple lesions; 13 cases were mostly round, 8 cases had uniform density/signal; necrosis was seen in 7 cases; 9 cases showed progressive enhancement after enhancement scan, 7 of which were single nodules and 6 cases showed continuous enhancement. "Vascular floating sign" was seen in 11 cases, indicating no invasion of vessels.

Conclusion

PHL is rare, and when the clinical presentation and laboratory diagnosis are not specific, the diagnosis of PHL should be considered when there is a single lesion in the liver with progressive enhancement and "vascular floating sign" on imaging.The diagnosis of PHL is suggested by the presence of multiple lesions with "vascular floating signs" .

Key words: Primary hepatic lymphoma, Computed tomography, Magnetic resonance imaging

Yuxian Wu, Yayuan Feng, Lei Huo, Ningyang Jia, Juan Zhang. Study on the diagnostic value of imaging in primary hepatic lymphoma[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(05): 349-353.

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https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2023/V13/I05/349

Figures/Tables 5

References 23

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病例	年龄	性别	症状	肝炎	AFP	PIVKA	CA199	CEA	LDH
1	72	男	乏力、消瘦	—	—	—	—	—	—
2	64	女	体检	丙型肝炎	—	—	升高	—	—
3	34	男	右上腹痛	乙型肝炎	—	—	—	—	—
4	60	女	体检	—	—	—	—	—	升高
5	49	女	右上腹痛	—	—	—	—	—	—
6	44	女	右上腹痛、恶心、呕吐、尿黄	_	—	—	—	—	升高
7	43	女	肝功能异常	乙型肝炎	—	—	—	—	—
8	42	女	体检	—	—	—	—	—	—
9	63	女	右上腹痛	—	—	—	—	—	—
10	72	男	体检	—	—	—	—	—	—
11	44	女	体检	—	—	—	—	—	—
12	66	女	体检	乙型肝炎	—	—	—	—	—
13	66	女	体检	乙型肝炎	—	—	升高	—	升高
14	81	男	体检	—	—	—	—	—	—
15	71	男	体检	—	—	—	—	—	—

病例	年龄	性别	症状	肝炎	AFP	PIVKA	CA199	CEA	LDH
1	72	男	乏力、消瘦	—	—	—	—	—	—
2	64	女	体检	丙型肝炎	—	—	升高	—	—
3	34	男	右上腹痛	乙型肝炎	—	—	—	—	—
4	60	女	体检	—	—	—	—	—	升高
5	49	女	右上腹痛	—	—	—	—	—	—
6	44	女	右上腹痛、恶心、呕吐、尿黄	_	—	—	—	—	升高
7	43	女	肝功能异常	乙型肝炎	—	—	—	—	—
8	42	女	体检	—	—	—	—	—	—
9	63	女	右上腹痛	—	—	—	—	—	—
10	72	男	体检	—	—	—	—	—	—
11	44	女	体检	—	—	—	—	—	—
12	66	女	体检	乙型肝炎	—	—	—	—	—
13	66	女	体检	乙型肝炎	—	—	升高	—	升高
14	81	男	体检	—	—	—	—	—	—
15	71	男	体检	—	—	—	—	—	—

病例	检查方式	病灶数目	最大径(cm)	形态	密度信号	坏死	血管漂浮征	胆管受压	强化方式^*
1	CT	单发	4.2	类圆形	均匀	无	有	有	渐进强化
2	CT	多发	4.8	类圆形	不均匀	有	有	有	渐进强化
3	CT	单发	5.7	类圆形	均匀	无	有	有	渐进强化
4	CT	多发	5.0	类圆形	不均匀	有	有	无	渐进强化
5	CT	单发	11.7	不规则	不均匀	有	有	无	持续强化
6	CT	单发	16.1	不规则	不均匀	有	有	有	渐进强化
7	CT	单发	2.0	类圆形	均匀	无	无	无	持续强化
8	CT	单发	9.6	类圆形	不均匀	有	有	有	渐进强化
9	MRI	多发	10.6	类圆形	不均匀	有	有	无	持续强化
10	MRI	单发	5.0	类圆形	均匀	无	有	无	持续强化
11	MRI	单发	2.8	类圆形	均匀	无	无	无	持续强化
12	MRI	多发	6.8	类圆形	不均匀	有	有	无	持续强化
13	MRI	单发	2.0	类圆形	均匀	无	无	无	渐进强化
14	MRI	单发	4.4	类圆形	均匀	无	有	无	渐进强化
15	MRI	单发	2.8	类圆形	均匀	无	无	无	渐进强化

病例	检查方式	病灶数目	最大径(cm)	形态	密度信号	坏死	血管漂浮征	胆管受压	强化方式^*
1	CT	单发	4.2	类圆形	均匀	无	有	有	渐进强化
2	CT	多发	4.8	类圆形	不均匀	有	有	有	渐进强化
3	CT	单发	5.7	类圆形	均匀	无	有	有	渐进强化
4	CT	多发	5.0	类圆形	不均匀	有	有	无	渐进强化
5	CT	单发	11.7	不规则	不均匀	有	有	无	持续强化
6	CT	单发	16.1	不规则	不均匀	有	有	有	渐进强化
7	CT	单发	2.0	类圆形	均匀	无	无	无	持续强化
8	CT	单发	9.6	类圆形	不均匀	有	有	有	渐进强化
9	MRI	多发	10.6	类圆形	不均匀	有	有	无	持续强化
10	MRI	单发	5.0	类圆形	均匀	无	有	无	持续强化
11	MRI	单发	2.8	类圆形	均匀	无	无	无	持续强化
12	MRI	多发	6.8	类圆形	不均匀	有	有	无	持续强化
13	MRI	单发	2.0	类圆形	均匀	无	无	无	渐进强化
14	MRI	单发	4.4	类圆形	均匀	无	有	无	渐进强化
15	MRI	单发	2.8	类圆形	均匀	无	无	无	渐进强化

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