[Clinical and imaging diagnosis of primary hepatic lymphoma]

To investigate the clinical and imaging features of primary hepatic lymphoma (PHL).

Four PHL cases were analyzed retrospectively for clinical manifestations, transcatheter hepatic arterial angiography and CT features.

All the four cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examination. The main clinical manifestations included pain in the right upper quadrant and B symptoms of the lymphoma (fever, night sweating, and weight loss) in 3 patients. Three cases were complicated by chronic hepatitis or cirrhosis, and the other had renal transplantation two years ago. All these cases exhibited elevated serum lactate dehydrogenase (LDH) level, which was reduced after surgery or chemotherapy. Plain CT scan all identified hypodense lesions which did not display marked enhancement on the arterial phase and portal venous phase scans. On delayed phase scan, the border of the lesions became clear, and slight enhancement was observed in the peripheral and some partitions of the lesions. Angiographic imaging displayed slight tumor staining and arterial displacement in the liver in all the cases with thin tumor-supplying vessels. Global staining or abnormally thickened vessels were not seen.

A comprehensive evaluation of the clinical manifestations and imaging features can be helpful in the diagnosis of PHL, and serum LDH level may help to assess the therapeutic effect.