EURORAD ESR

Case 13970

Diffuse large B-cell lymphoma with bilateral renal involvement

Author(s)
Tyler Brown BS1, Clint Walters MD2, Darko Pucar MD PhD2, and Kandace Klein DO2

1Medical College of Georgia, School of Medicine, Augusta University
2 Medical College of Georgia, Augusta University, Department of Radiology & Imaging

1120 15th Street,
BA-1411 30912 Augusta,
United States of America;
Email:dpucar@augusta.edu
 
Patient
male, 50 year(s)
 
 
  • Figure 1
    Ultrasound liver transverse

    Ultrasound (transverse image) of the liver demonstrating a large heterogeneous liver lesion.

     
    Area of Interest: Abdomen; Liver; Imaging Technique: Ultrasound; Procedure: Cost-effectiveness; Special Focus: Lymphoma;
     
     
  • Figure 2
    Coronal CT

    Coronal CT showing a 12 cm liver mass with focal hyperdensity corresponding to haemorrhage.

     
    Area of Interest: Abdomen; Liver; Imaging Technique: CT; Procedure: Decision analysis; Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 3
    Coronal and axial T2-weighted MRI
     

    Coronal T2-weighted MRI revealing a large heterogeneous liver mass.

     
    Area of Interest: Liver; Imaging Technique: MR; Procedure: Decision analysis; Special Focus: Lymphoma;

    Axial T2-weighted MRI demonstrating rounded areas of hypointensity involving the lateral right upper pole and medial left upper pole of the right and left kidneys, respectively (arrows).

     
    Area of Interest: Kidney; Imaging Technique: MR; Procedure: Decision analysis; Diagnostic procedure; Special Focus: Lymphoma;

    Coronal T2-weighted MRI revealing rounded areas of hypointensity throughout the left renal parenchyma (arrows).

     
    Area of Interest: Kidney; Imaging Technique: MR; Procedure: Decision analysis; Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 4
    Rotating MIP, fused axial and coronal PET-CT pre-treatment
     

    Rotating MIP image demonstrating intensely increased uptake in the liver mass (arrowhead), upper pole of the right kidney (+), and throughout the left renal parenchyma (arrows).

     
    Area of Interest: Kidney; Liver; Imaging Technique: PET; Procedure: Staging; Special Focus: Lymphoma;

    Fused axial PET-CT showing intensely increased uptake in the liver mass.

     
    Area of Interest: Liver; Imaging Technique: PET-CT; Procedure: Staging; Special Focus: Lymphoma;

    Fused axial PET-CT showing intensely increased uptake in the lateral upper pole of the right kidney and medial upper pole of the left kidney (arrows).

     
    Area of Interest: Liver; Imaging Technique: PET-CT; Procedure: Staging; Special Focus: Lymphoma;

    Fused Coronal PET-CT demonstrating intensely increased uptake in the lateral upper pole of the right kidney (arrow).

     
    Area of Interest: Kidney; Imaging Technique: PET-CT; Procedure: Staging; Special Focus: Lymphoma;

    Fused Coronal PET-CT showing intensely increased uptake in the medial upper pole of the left kidney (arrow).

     
    Area of Interest: Kidney; Imaging Technique: PET-CT; Procedure: Staging; Special Focus: Lymphoma;
     
     
  • Figure 5
    Rotating MIP, fused axial and coronal PET-CT post-treatment
     

    Rotating MIP demonstrating complete metabolic response following 3 cycles of R-CHOP with normal urinary excretion of FDG in the bilateral renal collecting system.

     
    Area of Interest: Kidney; Liver; Imaging Technique: PET; Procedure: Treatment effects; Special Focus: Lymphoma;

    Fused Axial PET-CT showing no abnormal FDG uptake in the liver consistent with complete metabolic response following 3 cycles of R-CHOP.

     
    Area of Interest: Liver; Imaging Technique: PET-CT; Procedure: Treatment effects; Special Focus: Lymphoma;

    Fused Axial PET-CT showing complete metabolic response in the bilateral upper pole. There is normal urinary excretion of FDG in the bilateral collecting system.

     
    Area of Interest: Kidney; Imaging Technique: PET-CT; Procedure: Treatment effects; Special Focus: Lymphoma;

    Fused Coronal PET-CT revealing complete metabolic response of prior focus in the lateral upper pole of the right kidney after treatment (arrow). There is normal urinary excretion of FDG in the bilateral renal...

     
    Area of Interest: Kidney; Imaging Technique: PET-CT; Procedure: Treatment effects; Special Focus: Lymphoma;

    Fused Coronal PET-CT demonstrating complete metabolic response of prior focus in the medial upper pole of the left kidney (arrow). There is normal urinary excretion of FDG in the bilateral renal collecting systems.

     
    Area of Interest: Kidney; Imaging Technique: PET-CT; Procedure: Treatment effects; Special Focus: Lymphoma;
     
     
Ultrasound (transverse image) of the liver demonstrating a large heterogeneous liver lesion.
 
Coronal CT showing a 12 cm liver mass with focal hyperdensity corresponding to haemorrhage.
 
Coronal T2-weighted MRI revealing a large heterogeneous liver mass.
 
Axial T2-weighted MRI demonstrating rounded areas of hypointensity involving the lateral right upper pole and medial left upper pole of the right and left kidneys, respectively (arrows).
 
Coronal T2-weighted MRI revealing rounded areas of hypointensity throughout the left renal parenchyma (arrows).
 
Rotating MIP image demonstrating intensely increased uptake in the liver mass (arrowhead), upper pole of the right kidney (+), and throughout the left renal parenchyma (arrows).
 
Fused axial PET-CT showing intensely increased uptake in the liver mass.
 
Fused axial PET-CT showing intensely increased uptake in the lateral upper pole of the right kidney and medial upper pole of the left kidney (arrows).
 
Fused Coronal PET-CT demonstrating intensely increased uptake in the lateral upper pole of the right kidney (arrow).
 
Fused Coronal PET-CT showing intensely increased uptake in the medial upper pole of the left kidney (arrow).
 
Rotating MIP demonstrating complete metabolic response following 3 cycles of R-CHOP with normal urinary excretion of FDG in the bilateral renal collecting system.
 
Fused Axial PET-CT showing no abnormal FDG uptake in the liver consistent with complete metabolic response following 3 cycles of R-CHOP.
 
Fused Axial PET-CT showing complete metabolic response in the bilateral upper pole. There is normal urinary excretion of FDG in the bilateral collecting system.
 
Fused Coronal PET-CT revealing complete metabolic response of prior focus in the lateral upper pole of the right kidney after treatment (arrow). There is normal urinary excretion of FDG in the bilateral renal collecting systems.
 
Fused Coronal PET-CT demonstrating complete metabolic response of prior focus in the medial upper pole of the left kidney (arrow). There is normal urinary excretion of FDG in the bilateral renal collecting systems.
 
 
 
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