Multiple anechoic hepatic nodules in a patient with malignant lymphoma: report of a case with an emphasis on B-mode sonograms

We present a case of hepatic malignant lymphoma (ML) in which the hepatic ML nodules were imaged as round anechoic nodules with posterior echo enhancement, mimicking hepatic cysts on B-mode ultrasonography (US). However, the boundary echo between the nodules and the surrounding hepatic tissue seemed to be less distinct than that of a hepatic cyst. Contrast-enhanced US showed the nodules to be hypervascular, which ruled out the possibility of hepatic cysts. Our observation stresses the importance of boundary echo for the diagnosis of hepatic ML on B-mode US. We also offer a possible explanation for this phenomenon.