Intravascular Large B-Cell Lymphoma Mimicking Intrahepatic Cholangiocarcinoma

Area of Science:

• Oncology
• Radiology
• Hematology

Background:

• Intravascular large B-cell lymphoma (IVLBL) is a rare non-Hodgkin lymphoma.
• IVLBL presents diagnostic challenges due to nonspecific and varied clinical manifestations.
• Early and accurate diagnosis is crucial for effective patient management.

Purpose of the Study:

• To highlight the diagnostic utility of PET-CT in identifying systemic lesions of IVLBL.
• To increase awareness among clinicians regarding potential misdiagnosis of IVLBL, particularly hepatic involvement.
• To emphasize the importance of considering IVLBL in the differential diagnosis of unexplained symptoms and lesions.

Main Methods:

• Review of clinical cases and imaging findings of IVLBL.
• Utilization of Positron Emission Tomography-Computed Tomography (PET-CT) for systemic staging.
• Comparison of imaging features with other intra-abdominal pathologies.

Main Results:

• PET-CT demonstrated significant value in detecting widespread lesions characteristic of IVLBL.
• Hepatic lesions along Glisson's sheath were identified as a potential mimic of intrahepatic cholangiocarcinoma.
• Multimodality imaging aids in differentiating IVLBL from other malignancies.

Conclusions:

• PET-CT is an effective tool for the diagnosis and staging of IVLBL.
• Clinicians should consider IVLBL in their differential diagnosis, especially when hepatic lesions are present.
• Awareness of IVLBL's varied presentation, including mimics like hepatic lesions, is essential for timely diagnosis and treatment.