Table 1 Clinical and imaging characteristics of B cell indolent lymphomas undergoing histologic transformation

FL

60 years old

Asymptomatic adenopathy (waxing and waning)

Multiple, deep non-obstructive adenopathy

3%/30%

M > F

Signs of extranodal involvement

Splenomegaly or focal splenic lesions

Extranodal involvement: organomegaly or focal lesions

Bone marrow, liver, lungs, CNS (more common)

Thyroid, parotid, breast, testis, skin (less common)

FDG avidity: 91–100%

CLL/SLL

71 years old

Asymptomatic lymphocytosis^a

Adenopathy, splenomegaly,hepatomegaly

0.5–1%/16%

Increases with age

Peripheral adenopathy

Heterogeneous bone marrow infiltration (MRI)

Rare < 40 years old

Splenomegaly

Brain and meningeal enhancement (MRI)

Anemia, bleeding, infections (cytopenia)

FDG avidity: 73% (high avidity–shorter survival)

MZL

69 years old

0.5%/10%

MALT lymphoma

Organ specific symptoms

Adnexa oculi: enhancing issue infiltrating ocular appendages

Association:

Lung: lung nodules, consolidations, reticulation, peribronchial infiltrates

Helicobacter pylori infection

Gastrointestinal: smooth, polipoid or infiltrative lesions

Hashimoto thyroiditis

Clamydia Psittaci infection

Splenic MZL

Splenomegaly, cytopenia

Single or multiple focal splenic lesions or splenomegaly

Nodal MZL

Adenopathy

Adenopathy

FDG avidity: 49% (Ocular)–95% (Bronchial)

WM/LPL

60 years old

Recurrent infections, easy bruising

Bone marrow involvement (MRI)

0.5%/2.4%

Headache, Blurry vision

Diffuse: bones iso or hypointense to muscle

Neuropathy

Variegated: multiple enhancing foci in bone marrow

Organomegaly, adenopathy

+ Fractures

Lung, pleura, skin, liver involvement

CNS involvement (Bing-Neel syndrome)

T2 hyperintense hyperenhancing periventricular/subcortical foci

 Meningeal or spinal enhancement

Adenopathy

FDG avidity: 73%

NLPHL

Bimodal (childhood–4th decade)

Adenopathy

Adenopathy, splenomegaly, splenic lesions

0.73%/10%

Rare (500 cases/year in USA)