CTICasesPrimary Aortic B-Cell Lymphoma
Imaging findings
CT demonstrates soft tissue surrounding the abdominal aorta (with prior aortic stent graft) that is heterogeneously enhancing with a nodular component, initially suspected to be a periaortic hematoma or leaking aneurysm. PET/CT reveals intense FDG hypermetabolism of the periaortic soft tissue. MRI shows nodular peripheral enhancement without T1 signal characteristics of blood. Biopsy confirmed B-cell lymphoma.
Key takeaways
Primary aortic lymphoma is an extremely rare tumor that can present as a periaortic soft tissue mass mimicking periaortic hematoma, infected aneurysm, or retroperitoneal fibrosis on CT. The key differentiating feature is intense FDG hypermetabolism on PET, which is atypical for hematoma or thrombus. Tissue sampling is required for diagnosis.
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