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Primary hepatic diffuse large B-cell lymphoma: unusual presentation and imaging features.

Ekta Dhamija1, Kumble S Madhusudhan1, Shalimar2

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Primary hepatic lymphoma is rare and challenging to diagnose via imaging alone. This case highlights unusual MRI findings in a young pregnant woman, emphasizing the need for biopsy for definitive diagnosis.

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Area of Science:

  • Hepatology
  • Oncology
  • Radiology

Background:

  • Primary hepatic lymphoma (PHL) is a rare liver malignancy with poorly defined imaging characteristics.
  • PHL often mimics other focal hepatic lesions, complicating diagnosis.
  • Biopsy is typically required for definitive diagnosis of PHL.

Observation:

  • A 22-year-old pregnant woman presented with a solitary liver mass on ultrasonography, initially suspected to be focal nodular hyperplasia.
  • Post-partum contrast-enhanced magnetic resonance imaging revealed an atypical large mass with a central scar and peripheral diffusion restriction.
  • Diffusion-weighted imaging demonstrated characteristic features aiding in the diagnostic process.

Findings:

  • Magnetic resonance imaging (MRI) findings, including diffusion-weighted imaging (DWI), can reveal atypical features of PHL.
  • The imaging presentation in this case was unusual, differing from typical descriptions of hepatic lesions.
  • Histopathological examination via biopsy confirmed the diagnosis of primary hepatic lymphoma.

Implications:

  • This case underscores the importance of considering PHL in the differential diagnosis of liver masses, even in young individuals.
  • Advanced imaging techniques like DWI can provide crucial information for diagnosing rare hepatic malignancies.
  • Accurate and timely diagnosis of PHL is essential for appropriate patient management and treatment planning.