EURORAD ESR

Case 10645

Hodgkin-type post-transplantation systemic lymphoma

Author(s)
Tonolini Massimo, MD.

"Luigi Sacco" University Hospital,
Radiology Department;
Via G.B. Grassi 74
20157 Milan, Italy;
Email:mtonolini@sirm.org
 
Patient
male, 54 year(s)
 
 
  • Figure 1
    Early lumbar spine MRI (obtained at another facility)
     

    Sagittal (a) and axial (b) T1-weighted images show some scattered centimetric foci of low-signal intensity in the bone marrow of the lumbar vertebral bodies (arrows). No vertebral collapses.

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Sagittal (a) and axial (b) T1-weighted images show some scattered centimetric foci of low-signal intensity in the bone marrow of the lumbar vertebral bodies (arrows). No vertebral collapses.

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    The same abnormal signal intensity foci seen in some lumbare vertebral bodies show low- and high signal intensity in T2-weighted (c) and short-tau inversion recovery (STIR, d) images, respectively (arrows).

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    The same abnormal signal intensity foci seen in some lumbare vertebral bodies show low- and high signal intensity in T2-weighted (c) and short-tau inversion recovery (STIR, d) images, respectively (arrows).

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 2
    Follow-up MRI (lumbar spine images)
     

    Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.

     
    Area of Interest: Spine; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 3
    Pelvis MRI
     

    Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).

     
    Area of Interest: Pelvis; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).

     
    Area of Interest: Pelvis; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).

     
    Area of Interest: Pelvis; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).

     
    Area of Interest: Pelvis; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 4
    Total-body contrast-enhanced multidetector CT (MDCT)
     

    MDCT images show liver transplant and persistent splenomegaly (a,b), absent ascites, plus an ovoid non-necrotic adenopathy in the porta hepatis (arrow in b).

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Dilation; Special Focus: Lymphoma;

    MDCT images show liver transplant and persistent splenomegaly (a,b), absent ascites, plus an ovoid non-necrotic adenopathy in the porta hepatis (arrow in b).

     
    Area of Interest: Liver; Imaging Technique: CT-Angiography; Procedure: Dilation; Special Focus: Lymphoma;

    Several 1-4 cm non-confluent, non-necrotic adenopathies are seen in the mesentery and retroperitoneum (arrowheads).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Several 1-4 cm non-confluent, non-necrotic adenopathies are seen in the mesentery and retroperitoneum (arrowheads).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
Sagittal (a) and axial (b) T1-weighted images show some scattered centimetric foci of low-signal intensity in the bone marrow of the lumbar vertebral bodies (arrows). No vertebral collapses.
 
Sagittal (a) and axial (b) T1-weighted images show some scattered centimetric foci of low-signal intensity in the bone marrow of the lumbar vertebral bodies (arrows). No vertebral collapses.
 
The same abnormal signal intensity foci seen in some lumbare vertebral bodies show low- and high signal intensity in T2-weighted (c) and short-tau inversion recovery (STIR, d) images, respectively (arrows).
 
The same abnormal signal intensity foci seen in some lumbare vertebral bodies show low- and high signal intensity in T2-weighted (c) and short-tau inversion recovery (STIR, d) images, respectively (arrows).
 
Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.
 
Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.
 
Sagittal T1-(a), T2-weighted (b) and STIR (c) images show abnormal signal intensity of most bone marrow in the dorso-lumbosacral spine, consistent with extensive marrow infiltration. No vertebral collapses.
 
Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).
 
Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).
 
Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).
 
Extensive replacement of the bone marrow of most sacral bodies and wings, left iliac wing, right acetabulum, left ischium and proximal femur is seen with T1 hypointense signal (a) and STIR hyperintensity (b..d).
 
MDCT images show liver transplant and persistent splenomegaly (a,b), absent ascites, plus an ovoid non-necrotic adenopathy in the porta hepatis (arrow in b).
 
MDCT images show liver transplant and persistent splenomegaly (a,b), absent ascites, plus an ovoid non-necrotic adenopathy in the porta hepatis (arrow in b).
 
Several 1-4 cm non-confluent, non-necrotic adenopathies are seen in the mesentery and retroperitoneum (arrowheads).
 
Several 1-4 cm non-confluent, non-necrotic adenopathies are seen in the mesentery and retroperitoneum (arrowheads).
 
 
 
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