Contrast-enhanced Ultrasound Features of Primary Hepatic Lymphoma Are Different From Common Malignant Hepatic Tumors: A Comparative Study

Abstract

Objective: To investigate and compare the ultrasonic features of primary hepatic lymphoma (PHL) and other common hepatic malignancies, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, and colorectal liver metastasis (CRLM).

Methods: The ultrasound features and clinical data of pathologically proven PHL (n = 26) were compared with HCC (n = 26), intrahepatic cholangiocarcinoma (n = 26), and CRLM (n = 26).

Results: There were significant differences in elevated lactate dehydrogenase levels between the PHL group and the other three groups (p < 0.05). The probability of PHL infection with the hepatitis B virus was lower than that of the HCC groups (p < 0.05). The probability of elevated serum tumor markers in PHL was significantly lower than that in the other three groups (p < 0.05). On conventional ultrasound, the probability of regular morphology in PHL was significantly higher than that in the other three groups (p < 0.05). On contrast-enhanced ultrasound examination, the proportion of vessel penetration signs in PHL was significantly higher than that of the other three groups (p < 0.001). The proportion of PHL with isoenhancement or hypoenhancement in the arterial phase was significantly higher than in the HCC and CRLM groups (p < 0.05). The enhancement type of PHL was different than that of the CRLM group (p < 0.05).

Conclusion: Contrast-enhanced ultrasound features are useful in the preoperative and noninvasive differentiation of primary hepatic lymphoma and other malignant hepatic tumors.

Keywords: Colorectal liver metastasis; Contrast-enhanced ultrasound; Hepatocellular carcinoma; Intrahepatic cholangiocarcinoma; Primary hepatic lymphoma.