US, CT, and MRI of primary and secondary liver lymphoma.

Abstract

To describe the imaging findings in patients with pathologically proven hepatic lymphoma. Ultrasound, CT, and MRI studies in 23 patients with primary (11 patients) or secondary (12 patients) liver lymphoma were retrospectively reviewed. All patients had proven non-Hodgkin lymphoma; all imaging studies were obtained within 3 weeks of biopsy. No finding or group of findings was specific for the diagnosis of hepatic lymphoma. In 7 of 11 cases of primary lymphoma, a single well-defined lesion was seen. Secondary liver lymphoma occurred as multiple (8 of 12) or diffusely infiltrating lesions (3 of 12) in most cases; it appeared as a solitary lesion in only 1 case. When discrete focal lesions were identified, the lesions were hypo- to anechoic on ultrasound, hypodense on CT, and had low and high signal intensity on TI- and T2-weighted MRI, respectively. Although no one finding appears to be diagnostic of hepatic lymphoma, ultrasound that demonstrates a homogeneous, hypoechoic, through-transmitting lesion combined with CT that demonstrates a solid, low attenuation lesion is highly suggestive of primary liver lymphoma. Secondary liver lymphoma can have a greater variety of appearances and is more likely to be multiple or diffusely infiltrating lesions than a solitary lesion.