PMC9932890_01
(A) Through plain scan of the upper abdomen, it clearly showed the masses in the hilar region, but the masses in the spleen were not obvious. (B) Through contrast-enhanced CT, it could show the masses in the hilar region and splenic region, and the masses showed progressive and uneven enhancement. The hilar region nodules: plain scan 30HU arterial phase, 40HU portal vein phase, 52HU delayed phase, 65HU; spleen nodules: plain scan 35HU arterial phase, 46HU portal vein phase, 52HU delayed phase, 63HU; upper abdominal enhancement suggested: Further examination is recommended for hilar and splenic masses. (C, D) FDG metabolism of hilar mass, splenic mass and presacral mass on PET-CT increased, and finally PET-CT suggested that the three were homologous and had a high possibility of lymphoma.
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Because a hilar mass was showed after scanning the upper abdomen through CT, the patient was scheduled for further examination through contrast-enhanced ultrasound ( Figure 1 ).
(A) The tumor in the hilar region showed thickened blood vessels, located at the edge of the tumor (indicated by the arrow), and was enhanced and cleared earlier than the surrounding tissue. (B) The splenic mass (shown by the arrow) showed a peripheral to central enhancement pattern with uneven hypoenhancement, which was enhanced later and cleared earlier than normal splenic tissue. (C) In the presacral mass (shown by the arrow), the central vessels of the mass were enhanced first, and the enhancement began later than the peripheral tissues, with uneven hypoenhancement, and there were obvious filling defects, and the clearance was earlier than the peripheral tissues.
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The boundary between the three masses and surrounding tissues was obvious ( Figure 2 ).