Secondary periportal infiltration of the liver by a Burkitt lymphoma.

Generally, the SI of lymphoma is comparable on “inphase” and “out-of-phase” T1-weighted images. Lymphomas typically do not show significant enhancement on arterial phase images after the administration of Gd contrast agents, although a slight increase in SI may sometimes be seen in the late portal-venous phase.However, most lesions are isointense with the normal liver parenchyma on T1-weighted images acquired during the equilibrium phase. The SI of lymphomas that have a periportal distribution is non-specific, which may lead to an initial misdiagnosis of metastasis.
Most patients are treated with chemotherapy, although some physicians employ a multimodal approach involving additional surgery and radiotherapy. Although the prognosis is variable, a good response may be achieved if aggressive combination chemotherapy is performed early after onset.
Burkitt’s lymphoma is a mature B-cell lymphoma associated with Epstein-Barr-virus that is characterized by rapid proliferation and a propensity for extranodal sites of involvement such as the gastrointestinal tract and central nervous system. It affects primarily children and young adults. Since sonography is often the first imaging procedure performed in these patients, knowledge of the wide range of sonographic appearances is helpful for the recognition of Burkitt’s lymphoma.
Burkitt’s lymphoma appears to be curable in a high proportion of cases if treated with aggressive multiagent chemotherapy regimens.The use of autologous stem cell transplantation appears to benefit patients who have had chemotherapy-sensitive relapses.
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This is radiology images of the unenhanced T2-weighted single-shot HASTE images in axial (a, b) and coronal orientation (c) reveal a large, heterogeneous mass (arrows in a) infiltrating from the hilum along the portal tracts into the liver. On the unenhanced T1-weighted fatsuppressed image (d) the lesion appears homogeneously hypointense. The lesion shows heterogeneous enhancement on dynamic phase images acquired after the administration of contrast agent (e-g). Note that encasement of the portal vessels is clearly visible (arrows in e). Note, in addition, the tumor masses surrounding the gallbladder (arrows in g) and the infiltration of the kidneys (arrowheads in g)

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Secondary periportal infiltration of the liver by a Burkitt lymphoma.
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