Woman 62yo with 5 months history of epigastric pain and being treated as gastritis after gastroscopy. Ultrasound of liver reported as inhomogeneous fatty liver.
Ultrasound liver reviews 3 months later : US 1 manny hypoechoic focal lesions at peripheral area of liver with size 2-3 cm without bending vascular sign. (US 1 , US 2 CDI, US 3 central liver, US 4 liver elastography of this hypoechoic mass is hard 41kPa, normal liver is 18kPa) US 5 : big spleen .
MSCE with CE detected hepato slenomegaly with many nodules captured contrast in arterial phases.
No lymphadenomegalia in abdomen.
MRI of liver with gado Images with many area hyper intens, T1 captured gado enhanced peripheral ( MRI 1, 2 ,3 ,4).
Blood tests = HBV positive EBV IGG positive Wako test negative
Beta2 migroglobuline rised very high 8,341 UI/ IGG rised to 2,188 UI kappa IGG detected .
Summary: With US imaging , CTce MRI ce and blood tests diagnosis is PLL ( primary liver lymphoma ), wait for liver biopsy..