Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare extranodal marginal zone B-cell lymphoma, with non-specific clinical and radiologic features, making diagnosis challenging. We report a 20-year-old female with chronic hepatitis B who presented with a heterogeneously hypoechoic hepatic mass on ultrasound. Further evaluation with contrast-enhanced ultrasound, computed tomography, and magnetic resonance imaging revealed a solitary lesion with characteristic enhancement patterns and diffusion restriction. Ultrasound-guided biopsy confirmed MALT lymphoma. Literature review indicates that chronic inflammation, viral infection, and genetic abnormalities may contribute to its pathogenesis. Treatment approaches vary, including surgical resection, liver transplantation, chemotherapy, radiotherapy, and rituximab, reflecting the absence of standardized guidelines. Despite diagnostic difficulties, primary hepatic MALT lymphoma generally exhibits an indolent course and favorable prognosis. Early recognition and histopathologic confirmation are essential, and management should be individualized based on tumor characteristics and patient factors.

A 68-year-old man with no significant medical history was referred for evaluation of incidentally detected hepatic and splenic lesions found during imaging for rib fractures. Cross-sectional imaging with computed tomography, magnetic resonance imaging, and fluorodeoxyglucose F18 positron-emitting tomography revealed multiple variable-sized masses in the liver and spleen. Contrast-enhanced ultrasound (CEUS) using Sonazoid showed mild arterial enhancement, early washout, and a corresponding perfusion defect in the delayed (Kupffer) phase. Ultrasound- guided liver biopsy confirmed Burkitt lymphoma. The patient received systemic chemotherapy, resulting in marked regression of hepatic and splenic lesions on follow-up imaging. This case highlights the diagnostic value of CEUS in characterizing atypical hepatic lesions and its potential to raise early suspicion for lymphoma, facilitating timely biopsy and management.

PURPOSE: Steroids can be used as an adjuvant therapy in the management of mycoplasma pneumonia, but no definite guidelines for the use of steroids have been established. The purpose of this study was to analyze the current usage and effects of steroids in the management of childhood mycoplasma pneumonia in a secondary hospital in Korea. METHODS: We retrospectively reviewed the medical records of 152 patients who were admitted due to mycoplasma pneumonia. The patients were divided into 3 groups as follows: those who did not use steroids (81 patients, 53%), those who used steroids after their fever subsided (42 patients, 28%) and those who used steroids during fever (29 patients, 19%). RESULTS: In decreasing order of values, the duration of fever during hospitalization (60.0±40.2 hours vs. 37.3±28.5 hours vs. 29.7±29.5 hours, P=0.006) and duration of hospitalization (5.9±1.7 days vs. 5.0±1.4 days vs. 4.0±1.5 days, P < 0.001) were reported in the group which received steroids during fever, the group which received steroids after the fever subsided and the group which did not receive steroids. In the group which received steroids during fever, patients with early steroid use (within 24 hours) had a shorter fever duration in the hospital (12.0 hours vs. 73.5 hours, P < 0.001) and a hospitalization duration (5.0 days vs. 6.5 days, P=0.007) than those with late steroid use (after 24 hours). CONCLUSION: Steroids were used in 47% of patients with mycoplasma pneumonia. The patients who received early steroids had a shorter fever duration and a shorter hospital stay than those who received late steroids.
Child ; Fever ; Hospitalization ; Humans ; Korea ; Length of Stay ; Medical Records ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Retrospective Studies ; Steroids*