Primary hepatic lymphoma | Secondary hepatic lymphoma | ||
---|---|---|---|
Clinical | Definition | Lymphoma confined to the liver and perihepatic nodal sites (without distant involvement) at time of presentation | Lymphoma that secondarily affects the liver |
Incidence | 1 % of non-Hodgkin lymphoma | 50 % of non-Hodgkin lymphoma 20 % Hodgkin lymphoma | |
Associations | Epstein-Barr virus, hepatitis B and C infection, HIV infection and cirrhosis | - | |
Presenting complaints | Right upper quadrant pain, jaundice (10-20 %) | Systemic symptoms (B symptoms) such as fever, night sweats, weight loss | |
Clinical examination | Hepatomegaly/ palpable liver | Systemic lymphadenopathy, hepatosplenomegaly | |
Bone marrow involvement/ Leukemic blood profile | Absent (for at least for 6 months after first presentation) | Present | |
Radiological | Lesion distribution | Solitary discrete lesion (60 %), multiple lesions (35-40 %) | Multifocal lesions or diffuse infiltration (90 %) Miliary shadows (10 %) |
Dominant mass(es) | Typically present | Usually absent | |
Morphology | Heterogeneous | Homogeneous | |
Enhancement | Heterogeneous | Heterogeneous | |
Splenic lesions | Absent | Present (30-40 %) | |
Supra-and/or infra-diaphragmatic lymphadenopathy | Absent | Present |