Year 2024 / Volume 116 / Number 6
Letter
An unusual cause of liver lesions

349-350

DOI: 10.17235/reed.2023.9787/2023

María Hernández, Yurami Leonor Sánchez, Asunción Ramos Meca,

Abstract
We present the case of a 68-year-old female with no relevant medical history,   who is evaluated for weight loss. An initial blood test showed mild hypertransaminasemia with negative serologies, autoimmunity and tumoral markers. Abdominopelvic CT revealed multiple liver lesions with ring enhancement, compatible with metastasis, as well as suspicious subcarinal adenopathy. The study was completed with gastroscopy and colonoscopy, mammography and fibrobroncoscopy with punction of the adenopathy, without finding out any lesion. Abdominal ultrasound was performed, presenting multiple isoecogenic liver lesions along both lobes, with a maximum diameter of 35 mm, surrounded by a hypoechoic halo, and no Doppler Signal. In contrast-enhanced ultrasound (CEUS), these lesions had centripetal enhancement in the arterial phase and progressive washout, compatible with metastasis as well. A percutaneous biopsy of one of the lesions was taken, showing infiltration of diffuse large B-cell lymphoma. At this moment, the patient is in remission after taking chemotherapy treatment.
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References
1. Alves, A. M. A., Torres, U. S., Velloni, F. G., Ribeiro, B. J., Tiferes, D. A., & D’Ippolito, G. (2019). The many faces of primary and secondary hepatic lymphoma: Imaging manifestations and diagnostic approach. Radiologia Brasileira, 52(5), 325–330.
2. Li, S., Young, K. H., & Medeiros, L. J. (2018). Diffuse large B-cell lymphoma. In Pathology (Vol. 50, Issue 1, pp. 74–87). Elsevier B.V.
3. Tomasian, A., Sandrasegaran, K., Elsayes, K. M., Shanbhogue, A., Shaaban, A., & Menias, C. O. (2015). Hematologic malignancies of the liver: Spectrum of disease. Radiographics, 35(1), 71–86.
4. He Hongfei, Zhang Lichao, Hou Senlin. Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of nonHodgkin’s diffuse large B-cell lymphoma with pancreatic metastasis. Rev Esp Enferm Dig 2022. doi: 10.17235/reed.2022.9384/2022
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Hernández M, Sánchez Y, Ramos Meca A. An unusual cause of liver lesions. 9787/2023


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Publication history

Received: 14/06/2023

Accepted: 24/06/2023

Online First: 04/08/2023

Published: 04/06/2024

Article Online First time: 51 days

Article editing time: 356 days


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