Hepatic Reactive Lymphoid Hyperplasia and Primary Hepatic Lymphoma: Ultrasound Features and Differentiation Diagnosis

Abstract

Objective: To investigate the ultrasound features of hepatic reactive lymphoid hyperplasia (HRLH) and primary hepatic lymphoma (PHL), and determine the value of ultrasound on the diagnosis and differentiation of them. Methods: The ultrasound findings of 11 HRLH lesions and 14 PHL lesions from April 2011 to September 2020 were retrospectively analyzed. The conventional ultrasound and contrast-enhanced ultrasound (CEUS) manifestations of them were compared. Results: HRLH showed significant female preference than PHL (100% and 64.3%) (P = 0.046). There were no significant differences of other demographics between HRLH and PHL patients. On conventional ultrasound, the diameter of HRLH (16.5 ± 3.8 mm) was significantly smaller than that of PHL (48.3 ± 36.2 mm) (P = 0.008), and a regular shape was seen more frequently in HRLH (90.9%) than that in PHL (50%) (P = 0.038). There were no significant differences of other indexes between HRLH and PHL. On CEUS, both HRLH and PHL presented arterial enhancement and washout in early portal phase. But rim enhancement at the beginning of washout was seen more frequently in HRLH (90.0%) than that in PHL (33.3%) (P = 0.036), and HRLH usually displayed hyperenhancement (100%) in arterial phase while PHL could be hypoenhancement (16.7%), isoenhancement (33.3%) and hyperenhancement (50%) (P = 0.036). Conclusion: Ultrasound can supply valuable imaging evidences for the diagnosis of HRLH and PHL. The ultrasound features including size, shape, degree of arterial phase enhancement and rim enhancement at the beginning of washout can be used for the differentiation of HRLH and PHL.

Keywords

• |hepatic reactive lymphoid hyperplasia|primary hepatic lymphoma|ultrasound