Bibliographic Details
| Title: |
Reactive lymphoid hyperplasia of the liver: A case report featuring characteristic nodular and perinodular enhancement |
| Authors: |
Hirohito Osanai, MD, Kazuto Kozaka, MD, PhD, Norihide Yoneda, MD, PhD, Kotaro Yoshida, MD, PhD, Azusa Kitao, MD, PhD, Toshifumi Gabata, MD, PhD, Kenichi Harada, MD, PhD, Isamu Makino, MD, PhD, Satoshi Kobayashi, MD, PhD |
| Source: |
Radiology Case Reports, Vol 19, Iss 5, Pp 1998-2003 (2024) |
| Publisher Information: |
Elsevier, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Medical physics. Medical radiology. Nuclear medicine |
| Subject Terms: |
Reactive lymphoid hyperplasia, Pseudolymphoma, Perinodular enhancement, Comet and comet-tail appearance, Medical physics. Medical radiology. Nuclear medicine, R895-920 |
| More Details: |
A 53-year-old female with primary biliary cholangitis was referred for the evaluation of a hepatic nodule identified during routine imaging. Ultrasonography revealed a homogeneous, hypoechoic, 18 mm nodule in segment 3 of the liver. On dynamic CT and MRI, the nodule showed mild enhancement at the hepatic artery-dominant phase. On diffusion-weighted images, the nodule exhibited pronounced hyperintensity with accompanying wedge-shaped perinodular hyperintensity (comet and comet-tail appearance). The nodule showed a portal perfusion defect on CT during arterial portography, and mild enhancement on CT during hepatic arteriography (CTHA). A nodular and wedge-shaped perinodular enhancement (comet and comet-tail appearance) in the CTHA was also clearly observed. The nodule demonstrated abnormal FDG uptake on 18F-FDG-PET/CT. An excisional biopsy was performed for histopathological diagnosis, and the nodule was diagnosed as reactive lymphoid hyperplasia (RLH). Diagnosing hepatic RLH by imaging is challenging due to its imaging findings overlapping with those of various malignant tumors, especially the nodular type of lymphomas, making differentiation particularly difficult. However, radiologists should note the perinodular early enhancement and the perinodular hyperintensity on diffusion weighted images, which are thought to be key imaging findings of RLH, along with other characteristics such as a single, small, homogeneous nodule with mild early enhancement and marked restricted diffusion. We propose to name the nodular lesion with perinodular early enhancement/hyperintensity on diffusion weighted images as 'comet and comet-tail appearances'. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1930-0433 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S1930043324001201; https://doaj.org/toc/1930-0433 |
| DOI: |
10.1016/j.radcr.2024.02.029 |
| Access URL: |
https://doaj.org/article/c988090edcc9495d8e896c0256778023 |
| Accession Number: |
edsdoj.988090edcc9495d8e896c0256778023 |
| Database: |
Directory of Open Access Journals |
