Magnetic resonance imaging features of primary splenic lymphoma
ZHANG Hongtao1, SHENG Fugeng1, ZHANG Zhaoxue1, GAO Shen1, CUI Mengqiu2, XU Wei2, YE Huiyi2
1. Department of Radiology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China; 2. Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Abstract：Objective To analyze the magnetic resonance (MR) imaging features of primary splenic lymphoma.Methods The clinical data and MR imaging features of patients with pathologically-proved primary splenic lymphoma were retrospectively analyzed from January 2010 to June 2019. The following MRI features of the lesions were analyzed: signal intensity, necrosis, hemorrhage, cystic change, pseudo-capsule, enhancement features and invasion of surrounding structures. Divided into two groups according to single or multiple lesions, the clinical data and MRI features of the lesions were compared.Results A total of 13 patients with primary splenic lymphoma were collected (8 cases were single and 5 cases were multiple with a total of 34 lesions). Fourteen lesions (41.2%) showed iso- and hyperintense and 20 lesions (5.82.2%) showed hypointense on T2WI; 30 lesions (88.2%) showed iso- and hypointense and 4 lesions (11.8%) showed hyperintense on T1WI; 15 lesions (44.1%) showed hyperintense on diffusion-weighted imaging (DWI), including 6 heterogeneous hyperintense lesions (40.0%) and 19 lesions (55.88%) showed iso- and hypointense; tumor necrosis occurred in 11 lesions (32.4%), hemorrhage occurred in 6 lesions (17.7%), and no lesions had cystic change; 20 lesions (58.8%) had pseudo-capsule, of which 11 lesions (55.0%) had incomplete pseudo-capsule. All the lesions on dynamic contrast-enhanced MRI showed mild enhancement in the arterial phase and gradually enhanced. One patient (7.7%) had invasion of the pancreas, and one patient (7.7%) had invasion of the splenic flexure of colon. The size of the lesion, T2WI and DWI signal characteristics, and the presence or absence of pseudo-capsule were statistically different between the two groups (P＜0.05).Conclusions The single lesion of primary splenic lymphoma is larger in diameter, T2WI and DWI show iso- and hyperintense, and pseudo-capsule is more common, while the multiple lesions show mostly hypointense on T2WI and DWI. The lesions in the two groups mostly show iso- and hypointense on T1WI, bleeding and necrosis can occur, and the dynamic contrast-enhanced scan shows mild progressive enhancement.
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