EURORAD ESR

Case 15505

Appearances can be deceptive: Burkitt lymphoma mimicking infectious disease in a child

Author(s)
Cassar Scalia A, Fiocchi F, Gibertini MC, Torricelli P

Policlinico di Modena-Università di Modena e Reggio Emilia, Istituto di Radiologia; del Pozzo 71 41100 Modena, Italy; Email:federica.fiocchi@gmail.com
 
Patient
male, 8 year(s)
 
 
  • Figure 1
    Neck Ultrasound
     

    Neck ultrasound shows enlarged hypervascular lymph nodes (a: B-mode).

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound; Procedure: Abscess delineation; Special Focus: Lymphoma;

    Neck ultrasound shows enlarged hypervascular lymph nodes (b: colorDoppler).

     
    Area of Interest: Head and neck; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Abscess delineation; Special Focus: Lymphoma;
     
     
  • Figure 2
    Abdominal ultrasound
     

    Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).

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

    Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).

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

    Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 3
    Abdominal MR (T1w and T2w)
     

    Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).

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

    Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).

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

    Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).

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

    Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 4
    Abdominal MR (DWI)
     

    Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).

     
    Area of Interest: Abdomen; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).

     
    Area of Interest: Abdomen; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).

     
    Area of Interest: Abdomen; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).

     
    Area of Interest: Abdomen; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
  • Figure 5
    Abdominal MR (T1w after contrast administration)
     

    Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;

    Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;

    Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;

    Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;
     
     
  • Figure 6
    Neck MR (T1w and T2w)
     

    Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast...

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast...

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;

    Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast...

     
    Area of Interest: Head and neck; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Lymphoma;
     
     
  • Figure 7
    Neck MR (DWI)
     

    Neck large solid mass with high signal on DWI (a: b value = 0, b: b value = 1000).

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;

    Neck large solid mass with high signal on DWI (a: b value = 0, b: b value = 1000).

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Lymphoma;
     
     
Neck ultrasound shows enlarged hypervascular lymph nodes (a: B-mode).
 
Neck ultrasound shows enlarged hypervascular lymph nodes (b: colorDoppler).
 
Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).
 
Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).
 
Numerous hypo-anechoic lesions in the renal (a) and hepatic (b) parenchyma, with peripheral vascularization at color-Doppler examination (c).
 
Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).
 
Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).
 
Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).
 
Abdominal MRI demonstrates hepatic and renal lesions hyperintense in T2-weighted sequences (a) and T2w fat sat (b), hypointense in T1-weighted ones (c: in phase, d: out of phase).
 
Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).
 
Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).
 
Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).
 
Abdominal MR demonstrates multiple hepatic and renal lesions with high signal in diffusion-weighted images (a: b value = 0, b: b value = 330, c: b value = 660, d: b value = 1000).
 
Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).
 
Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).
 
Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).
 
Hypovascular hepatic and renal lesions with apparent peripheral rim-enhancement in T1w images after contrast administration (a: no contrast; b: arterial phase; c: portal phase; d: late phase).
 
Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast administration).
 
Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast administration).
 
Large solid mass with origin from the pharyngeal tonsil and extension to rhinopharynx, nasal fossa and pterygopalatine fossa reaching prevertebral space (a: axial T2w; b, c: axial and coronal T1w after contrast administration).
 
Neck large solid mass with high signal on DWI (a: b value = 0, b: b value = 1000).
 
Neck large solid mass with high signal on DWI (a: b value = 0, b: b value = 1000).
 
 
 
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