Conclusion:
PTLD represents a variety of conditions with prognosis depending on the
grade of lymphoid proliferation. Knowledge of the distribution and
radiologic features of PTLD allows the radiologist to play a pivotal
role in making an early diagnosis, in guiding biopsy, and in the
surveillance of treatment response in patients with PTLD.
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Figures :
Figure 1-Ultrasonogram of liver:
A. Intercostal axial view of the liver shows an approximately 10x6cm
sized well-defined heterogeneously hypoechoic lesion in segment VIII of
the liver.
B. Colour and Spectral Doppler of the same lesion show mild internal
vascularity with RI=0.60.
Figure 2:
Axial sections of the plain (A),
arterial (B) and portovenous (C) phases of the CT abdomen show a
well-defined 8.7x5.2x6cm (APxTRxCC) sized hypodense lesion in the
segment VIII of the liver that shows progressive heterogenous contrast
enhancement. There is no calcification.
Figure
3:
Axial sections of the plain (A), arterial (B) and portovenous (C) phases
of the CT abdomen show another
well-defined 5.2x4.2x5.3cm (APxTRxCC) sized hypodense lesion in the
segment VI of the liver that shows heterogenous progressive peripheral
nodular contrast enhancement. Central area of the lesion is
non-enhancing. There is no calcification.
Both the kidneys are atrophic.
Figure
4:
T2 weighted axial sections of the MRI abdomen show two well-defined
heterogeneously hyperintense lesions in the segment VIII (A) and VI (B)
of the liver. The lesion in the segment VIII measures 9x5.5x6cm
(APxTRxCC) and the lesion in the segment VI measures 4.8x5.2x5.6cm
(APxTRxCC).
Figure
5:
The lesions in the segment VIII (A) and VI (B) show diffusion
restriction on DWI with a corresponding drop on ADC. The central area of
the lesions does not show diffusion restriction.
Figure 6:
On contrast enhanced MRI of the abdomen, the lesion in segment VIII
shows heterogenous enhancement (A), the lesion in segment VI shows
peripheral nodular enhancement with central non-enhancing area (B).