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We present the case of a 68-year-old female with no relevant medical history,   who is evaluated for weight loss. An initial blood test showed mild hypertransaminasemia with negative serologies, autoimmunity and tumoral markers. Abdominopelvic CT revealed multiple liver lesions with ring enhancement, compatible with metastasis, as well as suspicious subcarinal adenopathy. The study was completed with gastroscopy and colonoscopy, mammography and fibrobroncoscopy with punction of the adenopathy, without finding out any lesion. Abdominal ultrasound was performed, presenting multiple isoecogenic liver lesions along both lobes, with a maximum diameter of 35 mm, surrounded by a hypoechoic halo, and no Doppler Signal. In contrast-enhanced ultrasound (CEUS), these lesions had centripetal enhancement in the arterial phase and progressive washout, compatible with metastasis as well. A percutaneous biopsy of one of the lesions was taken, showing infiltration of diffuse large B-cell lymphoma. At this moment, the patient is in remission after taking chemotherapy treatment.

Citation

María Hernández, Yurami Leonor Sánchez, Asunción Ramos Meca. An unusual cause of liver lesions. Revista espanola de enfermedades digestivas. 2024 Jun;116(6):349-350

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PMID: 37539593

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