Ultrasound diagnosis and differential diagnosis of primary hepatic lymphoma / 中华肝胆外科杂志

ABSTRACT

Objective To investigate the diagnostic value of ultrasound in primary hepatic lymphoma (PHL).Methods The ultrasonic and clinical features in 40 cases of PHL were analyzed retrospectively.All cases were pathologically confirmed by surgical operation or ultrasound-guided biopsy.Results The most common presentation of PHL was a solitary lesion which occurred in 57.5％ (23/40) of patients,followed by multiple lesions in 30.0％ (12/40),and diffuse infiltration patterns in 12.5 ％ (5/40).The first two types were usually shown on ultrasound as hypoechoic lesions with surrounding normal liver parenchyma in 88.6％ (31/35) of cases.The diffuse pattern presented as diffuse hepatomegaly without nodules in the liver parenchyma.There were 52.5％ (21/40) of the lesions which could not be diagnosed either as benign or malignant by ultrasound.Conclusions The clinical presentations and imaging features of PHL are non-specific.PHL should be considered as a differential diagnosis in cases of liver metastases when no primary tumour is apparent,or when sonographic findings show atypical features of primary liver carcinoma or hemangioma.When patients with unexplained fever and diffuse hepatomegaly,PHL should be considered and precaution should be taken to prevent to misdiagnose these patients as having fatty liver or chronic liver disease.