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Table 1 Clinical and radiological manifestations of primary vs. secondary hepatic lymphoma

From: The imaging conundrum of hepatic lymphoma revisited

  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