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Sonographic Features of Liver Involvement by Lymphoma

Departments of Gastroenterology and Hepatology (J.F.C., E.M., M.B.D., J.E.D.) and Pathology (I.A., J.F.), University Hospital of Santiago, Santiago de Compostela, Spain.

Address correspondence to Javier F. Castroagudín, MD, Hospital Clínico Universitario de Santiago, C/Choupana s/n, 15706 Santiago de Compostela, Spain. E-mail: javier.fernandez.castroagudin{at}sergas.es

Objective. The liver is one of the most frequent extranodal locations of non-Hodgkin lymphoma and Hodgkin disease. Nevertheless, lymphoma constitutes only 6% to 8% of focal lesions of the liver. Few studies have evaluated the sonographic patterns of lymphoma with liver involvement. The purpose of this study was to describe the sonographic features and to evaluate the accuracy of sonography for the diagnosis of lymphoma with liver infiltration. Methods. The abdominal sonographic findings of 23 consecutive patients with histologically proven diagnosis of lymphoma with liver involvement were reviewed. Results. The most prevalent sonographic features were hepatomegaly and splenomegaly. Abdominal lymphoadenopathies were identified in 34.8% of cases. Liver nodules were seen in half of patients, and the most frequent sonographic appearance was as multiple small focal lesions. Differences in sonographic patterns between high- and low-grade non-Hodgkin lymphoma were not seen. None of the patients with Hodgkin disease had liver nodules. Concordance between sonography and computed tomography for the diagnosis of focal liver lesions was observed. Conclusions. Sonography may contribute to the diagnosis of liver infiltration by lymphoma. The presence of multiple focal liver lesions associated with splenomegaly and lymphoadenopathies should make us consider the diagnosis of lymphoma with liver involvement. Nevertheless, the low specificity of these findings requires histologic confirmation of lymphomatous infiltration of the liver.

Key Words: Hodgkin disease • liver • non-Hodgkin lymphoma • sonography

Abbreviations: CT, computed tomography • FNAB, fine-needle aspiration biopsy