Usefulness of contrast-enhanced ultrasonography for localized diffuse large B-cell lymphoma in the liver

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  • TESHIMA Syoichiro
    Department of Clinical Laboratory, National Hospital Organization Nagasaki Medical Center
  • NISHIURA Tetsuya
    Department of Clinical Laboratory, National Hospital Organization Nagasaki Medical Center
  • KOBAYASHI Mami
    Department of Clinical Laboratory, National Hospital Organization Nagasaki Medical Center
  • FUJITA Hisayuki
    Department of Clinical Laboratory, National Hospital Organization Nagasaki Medical Center
  • MAKINO Kenji
    Department of Radiology, National Hospital Organization Nagasaki Medical Center
  • NAGAOKA Shinya
    Department of Hepatology, National Hospital Organization Nagasaki Medical Center
  • MIURA Shiro
    Department of Pathology, National Hospital Organization Nagasaki Medical Center
  • ITO Masahiro
    Department of Pathology, National Hospital Organization Nagasaki Medical Center

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Other Title
  • 造影超音波検査が有用であった肝原発DLBCLの1例
  • ゾウエイ チョウオンパ ケンサ ガ ユウヨウ デ アッタ カン ゲンパツ DLBCL ノ 1レイ

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Abstract

<p>The patient was a man in his 70s. During his previous doctor’s visit, he presented with pneumonia and a liver mass. Four months later, a CT scan showed a rapid increase in the size of the liver mass. Thus, he was referred to our hospital for further examination. Abdominal ultrasound showed a solid tumor with a maximum diameter of 8 cm, and it had a branched lobe with clear boundaries and a notch in the margin. The interior showed uniformly low brightness and nonuniformly high brightness regions. The posterior echo was enhanced, and the existing peripheral vasculature traveled through the inside of the tumor. Contrast ultrasonography showed fine early dark staining of the entire mass in the arterial dominant phase. In the portal vein dominant phase, the contrast effect began to be attenuated from the surrounding liver parenchyma, and in the Kupffer phase, a clear defective image was obtained. On MRI, the masses exhibited low-intensity T1-weighted signals, high-intensity T2-weighted signals, high-intensity diffuse enhanced signals, and low-value ADC. In a dynamic study by GD-EOB-DTPA contrast MRI, the contrast effect on tumors was poor, and a septum-like structure that gradually increased in size was observed inside. In the hepatocellular phase, the tumor showed signals with lower intensities than the surrounding liver parenchyma． A tumor biopsy revealed diffuse large B-cell lymphoma (DLBCL). I would like to report on my experience with DLBCL cases where contrast ultrasound was useful for diagnosis.</p>

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