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.
Key words
magnetic resonance imaging /
primary splenic lymphoma /
diffusion weighted imaging
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