PMC10373583_01
Imaging findings of the patient. (A, B) Pelvic ultrasound: a 13.4 x 9.4 x 8.2 cm mass in the uterine region with clear borders, with rich blood flow signal detectable on CDFI and arterial spectrum detectable. (C, D) Pelvic MRI: significant increase in uterine volume, thickening of the muscular wall, measuring 5.6 cm at the thickest point, accompanied by diffuse abnormal signals and enhancement changes.
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F1
The pelvic ultrasound showed a 13.4 x 9.4 x 8.2 cm mass in the uterine region with clear borders, seemingly uterine morphology, hypoechoic inside, and a central endothelial line seemingly intermittent, about 1.2 cm thicker, with rich blood flow signal detectable on CDFI and arterial spectrum detectable, RI: 0.33 (Figures 1A, B). T1 and longer T2 signal predominating, and a heterogeneous signal in the T2WI, mixed with a few small patchy high-signal shadows, and the enhancement scan showed heterogeneous mild to moderate enhancement in the myometrial wall, which seemed to be caused by multiple nodules and masses fusion, and some of them were seen as patchy non-obvious enhancement shadows (Figures 1C, D), PET-CT showed an enlarged uterus with unclear endometrium, measuring ~12.6 x 11.7 cm. There is a significant diffuse increase in FDG metabolism in the uterus with a SUVmax of 36.34 (Figures 2A, B).
Imaging and pathological findings of the patient. (A, B) PET-CT: the uterus is enlarged, measuring -12.6 x 11.7 cm, with diffuse increased FDG metabolism, consistent with malignant changes. (C) Pathology: lymphoid cells arranged in a diffuse sheet pattern. (D) Abdominal CT after chemotherapy:a reduced uterine volume of -6.8 x 4.3 x 3.8 cm with less uniform density.
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F2
T1 and longer T2 signal predominating, and a heterogeneous signal in the T2WI, mixed with a few small patchy high-signal shadows, and the enhancement scan showed heterogeneous mild to moderate enhancement in the myometrial wall, which seemed to be caused by multiple nodules and masses fusion, and some of them were seen as patchy non-obvious enhancement shadows (Figures 1C, D), PET-CT showed an enlarged uterus with unclear endometrium, measuring ~12.6 x 11.7 cm. There is a significant diffuse increase in FDG metabolism in the uterus with a SUVmax of 36.34 (Figures 2A, B). Because of its specific imaging presentation, we performed an ultrasound-guided transabdominal uterine mass puncture biopsy for definitive diagnosis on the patient, and the pathology showed a non-Hodgkin diffuse large B-cell lymphoma of germinal center origin (Figure 2C). The abdominal enhancement CT showed a reduced uterine volume of ~6.8 x 4.3 x 3.8 cm with less uniform density (Figure 2D).