Abstract
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.
