US, CT, AND MRI OF PRIMARY AND SECONDARY LIVER LYMPHOMA

Objective: To describe the imaging findings in patients with pathologi cally proven hepatic lymphoma. Materials and Methods: Ultrasound, CT, and MRI studies in 23 patients with primary (11 patients) or secondary (12 patients) liver lymphoma were retrospectively reviewed. All patie nts had proven non-Hodgkin lymphoma; all imaging studies were obtained within 3 weeks of biopsy. Results: No finding or group of findings wa s specific for the diagnosis of hepatic lymphoma. In 7 of 11 cases of primary lymphoma, a single well-defined lesion was seen. Secondary liv er lymphoma occurred as multiple (8 of 12) or diffusely infiltrating l esions (3 of 12) in most cases; it appeared as a solitary lesion in on ly 1 case. When discrete focal lesions were identified, the lesions we re hypo- to anechoic on ultrasound, hypodense on CT, and had low and h igh signal intensity on T1- and T2-weighted MRI, respectively. Conclus ion: Although no one finding appears to be diagnostic of hepatic lymph oma, ultrasound that demonstrates a homogeneous, hypoechoic, through-t ransmitting lesion combined with CT that demonstrates a solid, low att enuation lesion is highly suggestive of primary liver lymphoma. Second ary liver lymphoma can have a greater variety of appearances and is mo re likely to be multiple or diffusely infiltrating lesions than a soli tary lesion.