HODGKINS AND NON-HODGKINS HEPATIC LYMPHOMA - SONOGRAPHIC FINDINGS

The sonographic studies of 72 patients with pathologically proven Hodg kin's or non-Hodgkin's hepatic lymphoma were retrospectively reviewed. Sixty-eight patients (94%) had secondary hepatic lymphoma (nine of th em had AIDS-related lymphoma) and four patients (6%) had primary lymph oma of the liver. Forty-six of 72 patients (64%) had diffuse hepatic i nvolvement, and 26 of 72 patients (36%) had focal liver lesions as dem onstrated by sonography. Four patterns of disease were identified: (a) hepatomegaly was depicted by sonography in 26 of the 59 patients with secondary hepatic lymphoma not related to AIDS, in two of the nine pa tients with AIDS-related secondary hepatic lymphoma, and in one of the four patients with primary hepatic lymphoma; (b) multiple rounded wel l delineated hypoechoic liver lesions were found in 22 of the 68 patie nts with secondary hepatic lymphoma; (c) a large heterogeneous echoic mass, which was an evocating clue to the diagnosis of primary lymphoma of the liver, was found in the four patients with primary lymphoma of the liver; and (d) an absence of sonographic abnormalities was found in 20 of the 59 patients with secondary lymphoma not related to AIDS. Liver involvement with lymphoma should be considered in any patient wh o develops multiple homogeneous hypoechoic liver masses, even in the a bsence of known underlying lymphomatous disease.