Park Kae Young, Yu Jeong Sik, Yoon Sang Wook, Park Mi Sook, Koo Ja Seung, Kim Ki Whang
Department of Diagnostic Radiology, Yongdong Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.
Yonsei Med J. 2004 Aug 31;45(4):723-6. doi: 10.3349/ymj.2004.45.4.723.
Imaging findings of secondary hepatic lymphoma have been reported as variable, ranging from single or multiple small nodules to diffuse infiltrative tumor patterns. We hear present a rare case report concerning aggressive B cells, secondary Burkitt's lymphoma in non-AIDS demonstrating a surprising periportal lymphoma infiltration, without upper abdominal lymphadenopathy or splenomegaly on the sonography and CT scans. Clinically, the case was characterized by atypical and highly aggressive course, with the patient presenting an abruptly developed obstructive jaundice with rapidly deteriorating hepatic function that could be indicative of cholestatic hepatitis, which differs in its clinical manifestations from hepatic lymphoma without functional deterioration in respect of its non-tissue destructive growth pattern. We suggest that hepatic lymphoma can sometimes be consistent with periportal infiltrating homogeneous mass, with no lymphadenopathy or splenomegaly on the imaging examination, with a predictable aggressive clinical course of the disease and poor prognosis.
继发性肝淋巴瘤的影像学表现报道不一，从单个或多个小结节到弥漫浸润性肿瘤模式都有。我们在此报告一例罕见病例，为非艾滋病患者的侵袭性B细胞继发性伯基特淋巴瘤，其在超声和CT扫描中显示出令人惊讶的门静脉周围淋巴瘤浸润，无上腹部淋巴结肿大或脾肿大。临床上，该病例的特点是病程不典型且高度侵袭性，患者突然出现梗阻性黄疸，肝功能迅速恶化，提示胆汁淤积性肝炎，其临床表现与无功能恶化的肝淋巴瘤不同，后者具有非组织破坏性生长模式。我们认为，肝淋巴瘤有时可能表现为门静脉周围浸润性均匀肿块，影像学检查无淋巴结肿大或脾肿大，疾病临床进程具有可预测的侵袭性且预后不良。
