Presentation
Known Diffuse Large B cell lymphoma completed chemotherapy, presented with abdominal distension
Patient Data
CT scan done 6 months ago showed normal enhancement of liver parenchyma. No focal lesion. Patient was asymptomatic at this time.
CT images during this presentation show irregular non enhancing hypodensities at periportal region. No mass effect. Mildly dilated intrahepatic biliary radicals. Associated enlarged paraaortic and paracaval lymph nodes.
Additional findings of dilated bilateral extra renal pelvis, ascites and bilateral pleural effusion.
Case Discussion
Periportal hypodensity represent excess fluid( blood, free fluid in interstitial space or dilated lymphatics) adjacent to portal/segmental veins. Various causes described, however in this clinical context, lymphoma with periportal infiltrative involvement of liver is highly suspected.
On imaging, it appears as hypodensity that is localized around the intrahepatic portal venous branches.
Case courtesy of Dr Mohd Fariq Bin Mohd Yusof, Radiologist Hospital Sultanah Aminah
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