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[A case of isolated hepatic malignant lymphoma representing characteristic findings on radiological imaging]
Nari Yamamoto1, Akihiro Nishie, Kengo Yoshimitsu
1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Insights
This case study highlights secondary hepatic malignant lymphoma, a rare liver complication. Characteristic radiological findings aided diagnosis and treatment of this lymphoma relapse, leading to positive patient outcomes.
Area of Science:
- Oncology
- Radiology
- Hepatology
Background:
- Malignant lymphoma can present with secondary hepatic involvement, posing diagnostic challenges.
- Chemotherapy is a primary treatment for malignant lymphoma, but relapse can occur.
Observation:
- An 80-year-old male with a history of malignant lymphoma developed a hepatic mass post-chemotherapy.
- Radiological imaging (CT/MRI) revealed a well-demarcated, hypovascular liver mass with a low apparent diffusion coefficient (0.70 x 10(-3) mm2/s).
- Elevated serum lactic dehydrogenase levels indicated active disease.
Findings:
- Radiological features suggested a highly cellular mass consistent with lymphoma relapse, characterized by growth without vascular destruction.
- The patient responded well to additional chemotherapy, with near-complete resolution of the hepatic mass.
- Serum lactic dehydrogenase normalized, indicating successful treatment.
Implications:
- Characteristic radiological findings are crucial for diagnosing secondary hepatic malignant lymphoma relapse.
- Early identification and prompt treatment of liver involvement in lymphoma patients can lead to favorable outcomes.
- This case underscores the importance of vigilant monitoring for extranodal relapse in lymphoma survivors.
Abstract:
We present an 80-year-old-man who showed characteristic radiological findings of secondary hepatic malignant lymphoma. The patient was first admitted to our hospital 6 months before with left cervical mass, which was diagnosed as malignant lymphoma by biopsy. After complete response to chemotherapy, a large hepatic mass appeared, as the serum value of lactic dehydrogenase elevated. CT/MRI showed a well-demarcated hypovascular mass, which was penetrated by the right hepatic vein. The apparent diffusion coefficient of the mass was 0.70 x 10(-3) mm2/s. The patient was diagnosed as relapse of malignant lymphoma, mainly based on these radiological findings reflecting the mass with high cellularity which grows without destruction of existing vascular structure, and additional chemotherapy was given. The hepatic mass disappeared almost all and the serum value of lactic dehydrogenase decreased with in normal range. The patient was discharged in a good condition 2 months later.
