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Second malignant neoplasms in lymphomas, secondary lymphomas and lymphomas in metabolic disorders/diseases. Cell Biosci 2022; 12:30. [PMID: 35279210 PMCID: PMC8917635 DOI: 10.1186/s13578-022-00763-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/14/2022] [Indexed: 12/02/2022] Open
Abstract
With inconsistent findings, evidence has been obtained in recent years that metabolic disorders are closely associated with the development of lymphomas. Studies and multiple analyses have been published also indicating that some solid tumor survivors develop a secondary lymphoma, whereas some lymphoma survivors subsequently develop a second malignant neoplasm (SMN), particularly solid tumors. An interaction between the multiple etiologic factors such as genetic factors and late effects of cancer therapy may play an important role contributing to the carcinogenesis in patients with metabolic diseases or with a primary cancer. In this review, we summarize the current knowledge of the multiple etiologic factors for lymphomagenesis, focusing on the SMN in lymphoma, secondary lymphomas in primary cancers, and the lymphomas associated to metabolic disorders/diseases, which have been received less attention previously. Further, we also review the data of coexistence of lymphomas and hepatocellular carcinoma (HCC) in patients with infection of hepatitis C virus and hepatitis B virus.
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Grewe S, Shahid M, Zhang L, Jiang K. Clinically unsuspected primary hepatic mucosa-associated lymphoid tissue lymphoma collision with an intrahepatic cholangiocarcinoma: A case report and literature review. SAGE Open Med Case Rep 2021; 9:2050313X211041838. [PMID: 34457305 PMCID: PMC8392794 DOI: 10.1177/2050313x211041838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/06/2021] [Indexed: 01/03/2023] Open
Abstract
A synchronous tumor represents two histologically distinct neoplasms occurring at the same anatomic site, each displaying a distinct tumorigenesis pathway; they can be primary, secondary, or a mixture. The occurrence of an adenocarcinoma and lymphoma has been reported in gastrointestinal and pulmonary sites; however, such a finding in hepatobiliary system remains elusive. Primary hepatic lymphoma is rare, while primary biliary mucosa-associated lymphoid tissue lymphoma is an even rarer event; hence, its collision with an intrahepatic cholangiocarcinoma could be entirely missed both in practice and in the literature. We herein reported a case of biliary mucosa-associated lymphoid tissue lymphoma occurring synchronously with an intrahepatic cholangiocarcinoma in a 78-year-old female following a biopsy-proven intrahepatic cholangiocarcinoma and hepatectomy. Microscopic examination identified atypical lymphoid population intermingled with this intrahepatic cholangiocarcinoma. An immunohistochemical panel uncovered an incidental mucosa-associated lymphoid tissue lymphoma occurring with this intrahepatic cholangiocarcinoma. This clinically missed entity led to comprehensive systemic investigation/staging, with subsequent detection of bone marrow involvement by stage IV lymphoma. This unique case highlights the importance of astute histomorphological evaluation and thorough ancillary studies in identifying a clinically unsuspected neoplasm in close contact with a known tumor.
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Affiliation(s)
| | | | | | - Kun Jiang
- Moffitt Cancer Center, Tampa, FL, USA
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Xu Z, Pang C, Sui J, Gao Z. A case of primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphoma treated by radiofrequency ablation (RFA), and a literature review. J Int Med Res 2021; 49:300060521999539. [PMID: 33730924 PMCID: PMC8166399 DOI: 10.1177/0300060521999539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare liver malignancy that usually lacks characteristic imaging findings and which is often misdiagnosed. We report a 63-year-old woman diagnosed with primary hepatic extranodal marginal zone B-cell lymphoma, MALT type. The patient underwent needle biopsy and radiofrequency ablation (RFA), and showed no signs of relapse during the 12-month postoperative follow-up. This case stresses the rarity of primary hepatic MALT-type lymphoma and the unique and effective treatment for this patient. Our patient received RFA, which showed good efficacy and which provides a new option for the treatment of hepatic MALT lymphoma. We also present our findings from a systematic review to improve the current understanding of this disease.
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Affiliation(s)
- Zhe Xu
- First Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Chong Pang
- First Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jidong Sui
- First Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Dalian Medical University, Dalian, China
| | - Zhenming Gao
- First Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Dalian Medical University, Dalian, China
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Postsurgical Diagnosis of an Unusual Case of Primary Hepatic Lymphoma Presenting as Liver Abscess with an Uncommon Complication: A Hepatogastric Fistula. Case Rep Hematol 2021; 2021:6647558. [PMID: 33680521 PMCID: PMC7929681 DOI: 10.1155/2021/6647558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 11/17/2022] Open
Abstract
Primary hepatic lymphoma (PHL) is a very rare malignancy and constitutes 0.016% of all cases of non-Hodgkin's lymphoma and 0.4% of extranodal non-Hodgkin's lymphoma. We describe a rare case of primary hepatic lymphoma presenting as liver abscess which was complicated with the development of a hepatogastric fistula. A 58-year-old man presented with clinical signs of sepsis, high-grade fever, right upper abdominal pain, and weight loss which had progressed in the past 8 months. Noncontrast abdominal computed tomography (CT) revealed a heterogeneously hypodense lesion in the left lobe of the liver with multiple air foci within, which are seen to extend into the body of the stomach. The patient was initially misdiagnosed as a case of rupture of liver abscess into the stomach. Postoperative liver biopsy examination confirmed a diagnosis of diffuse large B-cell lymphoma. Systemic staging revealed no evidence of nodal or bone marrow involvement, so PHL was diagnosed. Chemotherapy was initiated, but discontinued due to the patient's general condition. Finally, the patient succumbed to neutropenic fever following chemotherapy. Here, we present the exceptional case of a primary hepatic lymphoma with an unusual complication, a hepatogastric fistula, and try through the existing literature to show the difficulties involved in diagnosis and treatment.
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Abstract
PURPOSE OF REVIEW Imaging features of lymphoma vary regionally. Awareness of site-specific key imaging characteristics of lymphoma can aid in rapid staging and assist in prompt treatment. FDG PET/CT and conventional MRI are readily available diagnostic modalities with excellent sensitivity and good specificity. Diagnostic specificity can be enhanced using emerging PET radiotracers, e.g., FLT and FET. RECENT FINDINGS Emerging research has shown higher dimensional analysis (radiomics and radiogenomics) of imaging data can yield information of the underlying genetic aberrations in lymphoma, which can aid in assessing real-time evolution of tumor. CT, PET/CT, MRI, and ultrasound accentuate the intrinsic qualities of lymphoma (e.g., FDG PET/CT for increased metabolic activity, FLT PET/CT for increased proliferation index, and DWI for increased cellularity) and play an essential role in its diagnosis and examination. Advanced radiogenomic analyses use radiomic parameters to deduce genetic variations of lymphoma, providing noninvasive, repeatable, and real-time surveillance of its genetic progression.
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Qiu MJ, Fang XF, Huang ZZ, Li QT, Wang MM, Jiang X, Xiong ZF, Yang SL. Prognosis of primary hepatic lymphoma: A US population-based analysis. Transl Oncol 2020; 14:100931. [PMID: 33188980 PMCID: PMC7672323 DOI: 10.1016/j.tranon.2020.100931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/29/2022] Open
Abstract
Primary hepatic lymphoma (PHL) is a rare form of extranodal lymphomas, mainly invading the liver and local tissues. The incidence, clinical characteristics and survival of patients with PHL in the United States. An applicable PHL model can forecast the dynamic survival rate of patients with PHL.
Objective Primary hepatic lymphoma (PHL) is a rare malignancy with lesions confined to the liver. It is characterized by a large number of monomorphic, medium-sized lymphocytic infiltrates in the hepatic sinusoid. Due to the rarity of this malignancy, our current understanding of PHL is limited. Methods We collected incidence, mortality, and clinical data of PHL patients diagnosed between 1975 and 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. The annual percentage changes (APCs) and prognoses were analyzed using the Joinpoint and R package. Results Among the 1,372 patients, white males were prevalent, and the most common histological subtype was diffuse large B-cell lymphoma (DLBCL). The incidence and mortality rate of PHL was 0.075/100,000 person-years and 0.055/100,000 person-years, respectively. The annual incidence rate of PHL increased significantly, with an APC of 2.74% (P < 0.001). The 3- and 5-year overall survival (OS) rates of patients with PHL were 43.553% and 39.242%, respectively. The 3- and 5-year relative survival (RS) rates were 46.925% and 45.300%, respectively. Multivariate Cox regression analysis revealed that older age, black, DLBCL, and advanced-stage disease were independent predictors of unfavorable OS and RS. The C-index and receiver operating characteristic (ROC) analysis confirmed the prognostic value of the nomograms established in this study. Conclusion The nomogram established in this study is a robust tool to predict the prognosis of PHL patients.
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Affiliation(s)
- Meng-Jun Qiu
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Xie-Fan Fang
- Charles River Laboratories, Inc., 6995 Longley Lane, Reno, NV 89511, United States
| | - Zao-Zao Huang
- Yangchunhu Community Hospital, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Qiu-Ting Li
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Meng-Meng Wang
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Xin Jiang
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
| | - Zhi-Fan Xiong
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China.
| | - Sheng-Li Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Dantas E, Santos J, Coelho M, Sequeira C, Santos I, Cardoso C, Oliveira AP. Primary hepatic lymphoma in a patient with cirrhosis: a case report. J Med Case Rep 2020; 14:168. [PMID: 32977834 PMCID: PMC7519549 DOI: 10.1186/s13256-020-02471-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 07/28/2020] [Indexed: 02/07/2023] Open
Abstract
Background Primary hepatic lymphoma is a very uncommon disease. Due to its nonspecific clinical, laboratory, and imaging findings, it is often misdiagnosed. Liver biopsy is required to make a final diagnosis. Chemotherapy is the current gold standard of treatment. Case presentation An asymptomatic 65-year-old Caucasian man with Child-Pugh class A cirrhosis presented to our hospital with a nodular lesion seen on a routine surveillance abdominal ultrasound. His physical examination revealed hepatomegaly and no other significant findings. Magnetic resonance imaging of the abdomen showed a voluminous nodule on the left lobe with heterogeneous contrast enhancement. His liver biopsy was compatible with diffuse large B-cell lymphoma. Systemic staging showed no evidence of nodal or bone marrow involvement, confirming the diagnosis of primary hepatic lymphoma. He was treated with chemotherapy. However, he developed febrile neutropenia after one of the cycles and died. Conclusions In this article, we report a rare presentation of non-Hodgkin lymphoma and review the current literature on clinical features, diagnosis, and management.
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Affiliation(s)
- Eduardo Dantas
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.
| | - Joana Santos
- Oncology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Mariana Coelho
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Cristiana Sequeira
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Inês Santos
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Cláudia Cardoso
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Ana Paula Oliveira
- Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal
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Yasuda T, Nakagawa S, Imai K, Okabe H, Hayashi H, Yamashita YI, Chikamoto A, Ozono K, Mikami Y, Baba H. A case of primary hepatic mucosa-associated lymphoid tissue lymphoma incidentally found in the sustained virological response state of chronic hepatitis C: review of the literature of this rare disease. Int Cancer Conf J 2020; 9:59-65. [PMID: 32257755 DOI: 10.1007/s13691-019-00397-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023] Open
Abstract
A 54-year-old woman finished the treatment for chronic hepatitis C and achieved sustained virological response. She was identified with some tumor lesions at her liver during follow-up observation by ultrasonography. From contrast-enhanced computed tomography, there were four tumors at sub-segment 4/5, S5, S6, and S7. These lesions are slightly enhanced on arterial phase and washed out on delayed phase. Contrast-enhanced magnetic resonance imaging showed slight enhancement on arterial phase and defect on hepatocyte phase. Tumor markers including alpha fetoprotein, Des-Gamma-Carboxy Prothrombin, carcinoembryonic antigen, and carbohydrate antigen (CA19-9) were within normal range. The patient underwent partial hepatectomies of four tumors at S4/5, S5, S6, and S7. The patient was recovering well, so he discharged our hospital after 10 days from the operation. The histological assay of the resected specimen showed accumulation of lymphocyte with hyperplasia of lymphoid follicles accordant with tumor lesions. Immunohistochemical staining assay revealed a positive for CD3, CD20, CD10, and bcl-2. These findings eventually made a diagnosis of all four tumors as mucosa-associated lymphoid tissue lymphoma. Since previously published case reports and our case described nonspecific clinical features of this rare disease, it was difficult to get the certain diagnosis before histological confirmation and non-anatomical partial liver resection may be a good choice for both diagnosis and local therapy.
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Affiliation(s)
- Tadahito Yasuda
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Shigeki Nakagawa
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Katsunori Imai
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hirohisa Okabe
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hiromitsu Hayashi
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Yo-Ichi Yamashita
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Akira Chikamoto
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Kazutaka Ozono
- 2Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Yoshiki Mikami
- 2Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hideo Baba
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
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Karaosmanoglu AD, Uysal A, Onur MR, Hahn PF, Ayhan AS, Ozmen MN, Akata D, Karcaaltincaba M. Primary lymphomas of the intraabdominal solid organs and the gastrointestinal tract: spectrum of imaging findings with histopathological confirmation. Abdom Radiol (NY) 2019; 44:2988-3005. [PMID: 31209544 DOI: 10.1007/s00261-019-02100-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Unlike nodal lymphoma, primary lymphomas of the intraabdominal organs are uncommon neoplasms whose diagnosis may be challenging in certain clinical circumstances. Despite this difficulty for imaging diagnosis, there are several imaging features on ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography that may suggest the correct diagnosis. The scope of this review is to describe and illustrate the imaging features of primary lymphoma of intraabdominal organs providing clues to the diagnosis, together with their pathological correlations.
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Primary Hepatic Lymphoma Mimicking a Hepatocellular Carcinoma in a Cirrhotic Patient: Case Report and Systematic Review of the Literature. Case Rep Surg 2018; 2018:9183717. [PMID: 29850362 PMCID: PMC5914115 DOI: 10.1155/2018/9183717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/31/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Primary hepatic lymphomas (PHLs) are rare liver tumors, frequently misdiagnosed preoperatively. As these tumors could be successfully treated with chemotherapy, their early recognition is essential, potentially, to avoid useless surgery. We report on the case of a cirrhotic patient with hemochromatosis who presented a PHL, initially diagnosed as a hepatocellular carcinoma (HCC), and we analyze recent data from the literature on this subject. Case Presentation and Review of the Literature A 45 mm liver tumor was found is a 68-year-old man with alcohol cirrhosis and hemochromatosis. At imaging, the diagnosis of HCC was suspected according to vascular characteristics and the presence of cirrhosis. FDG PET scan showed a solitary hypermetabolic liver tumor. Tumor markers were negative. Surgery consisted in left lateral hepatectomy. At pathology, the diagnosis of the primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) type was demonstrated. Twenty-two articles reporting 33 cases of true PHL of MALT type were found. Presentation lacked specific symptoms (70% asymptomatic). Half of patients were suspected to have other etiologies of liver mass (HCC, intrahepatic cholangiocarcinoma), and thus diagnosis was established postoperatively. In the patient, diagnosis was made by preoperative biopsy, and chemotherapy was first-line treatment. Discussion Preoperative diagnosis of PHL, and particularly of primary hepatic MALT lymphoma, is challenging. This case illustrates that PHL remains to be considered among the differential diagnosis of isolated solid liver tumors. Further, it indicates that biopsy could be still indicated in case of suspected HCC in cirrhotic patients, particularly in the presence of unusual findings such as the combination of a FDG PET scan positive tumor in the absence of elevated alpha-fetoprotein.
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Cesaretti M, Loustau M, Robba C, Senescende L, Zarzavadjian Le Bian A. Reappraisal of primary hepatic lymphoma: Is surgical resection underestimated? Crit Rev Oncol Hematol 2018; 123:1-6. [DOI: 10.1016/j.critrevonc.2018.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 10/27/2017] [Accepted: 01/11/2018] [Indexed: 12/18/2022] Open
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Park JI, Jung BH. Primary hepatic lymphoma treated with liver resection followed by chemotherapy: a case report. Ann Hepatobiliary Pancreat Surg 2017; 21:163-167. [PMID: 28990004 PMCID: PMC5620478 DOI: 10.14701/ahbps.2017.21.3.163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 12/03/2022] Open
Abstract
Non-Hodgkin lymphoma often involves the liver. However, primary hepatic lymphoma (PHL) confined to the liver without evidence of lymphomatous involvement is rare. The optimal therapy for PHL is still unclear. Most patients present with poor prognostic features. Here, we report a case of PHL treated with liver resection followed by chemotherapy. A 65-year-old male was referred for further evaluation about a liver mass detected on ultrasound. Abdominal computed tomography (CT) scan showed well-defined single mass of 6 cm in diameter. Positron emission tomography/CT scan revealed a hot uptake lesion on the segment 8 of the liver. Colonoscopy showed no abnormal finding. It was diagnosed as intrahepatic cholangiocarcinoma. A right anterior sectionectomy was performed. Postoperative pathology revealed diffuse large B-cell lymphoma. Bone marrow biopsy showed normal findings. The final diagnosis was confirmed as PHL. The patient subsequently received six cycles of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone) regimen. The patient is doing well without relapse after 60 months of follow-up. Because of its rarity and the lack of specific laboratory, radiological, or clinical finding, liver biopsy is essential for definite diagnosis of PHL. Optimal treatment for PHL is currently uncertain. However, surgical resection followed by adjuvant chemotherapy should be considered for select individuals to achieve better outcome.
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Affiliation(s)
- Jeong-Ik Park
- Department of Surgery, Inje University Haeundae Paik Hospital, Inje Unviersity College of Medicine, Busan, Korea
| | - Bo-Hyun Jung
- Department of Surgery, Inje University Haeundae Paik Hospital, Inje Unviersity College of Medicine, Busan, Korea
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Forghani F, Masoodi M, Kadivar M. Primary Hepatic Lymphoma Mimicking Cholangiocarcinoma. Oman Med J 2017; 32:335-338. [PMID: 28804587 DOI: 10.5001/omj.2017.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Primary hepatic lymphoma (PHL) presenting with obstructive jaundice is rare and can mimic a preoperative diagnosis of cholangiocarcinoma. We should consider PHL in patients with radiological hepatic disease with normal serum alpha-fetoprotein and carcinoembryonic antigen levels, and elevated lactate dehydrogenase. We present the case of a 67-year-old male with no significant medical history presented with abdominal pain, jaundice, fever, and abnormal liver function tests. Abdominal sonography and computed tomography scan suggested a diagnosis of obstructive jaundice and cholangitis due to cholangiocarcinoma (Klatskin tumor). A subsequent liver biopsy diagnosed PHL, and the patient was treated with combination chemotherapy, including rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). PHL should be considered in patients presenting with biliary obstruction.
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Affiliation(s)
- Foroogh Forghani
- Colorectal Research Center, Department of Gastroenterology, Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Masoodi
- Colorectal Research Center, Department of Gastroenterology, Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Kadivar
- Department of Pathology, Rasoul-e-Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran
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Liao SH, Chen YK, Yu SC, Wu MS, Wang HP, Tseng PH. An unusual case of primary hepatic lymphoma with dramatic but unsustained response to bendamustine plus rituximab and literature review. SAGE Open Med Case Rep 2017; 5:2050313X17709190. [PMID: 28596829 PMCID: PMC5448865 DOI: 10.1177/2050313x17709190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 04/17/2017] [Indexed: 12/18/2022] Open
Abstract
Objectives: Primary hepatic lymphoma is an uncommon cause of hepatic space-occupying lesions. Methods: We describe the case of a 73-year-old man with primary hepatic lymphoma, who presented with a low-grade fever and lower limb weakness which had progressed in the past 2 months. Results: Abdominal ultrasound and computed tomography showed multiple small hepatic tumors. Echo-guided biopsy of the hepatic tumor demonstrated primary hepatic diffuse large B cell lymphoma. Moreover, bone marrow was uninvolved, but the bone marrow smear disclosed hemophagocytosis, which is uncommon in diffuse large B cell lymphoma. Chemotherapy with bendamustine and rituximab treatment was initiated with a dramatic response: hepatic tumors markedly shrank in size shown by follow-up computed tomography and the patient returned to his normal life. Nevertheless, the response was sustained for only 8 months. Finally, the disease resisted further chemotherapy and this patient died of a severe Klebsiella pneumoniae infection. Conclusion: Chemotherapy with bendamustine and rituximab has shown a dramatic, but not durable, response in the present case with old age and multiple comorbidities.
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Affiliation(s)
- Sih-Han Liao
- National Taiwan University Cancer Center, Taipei, Taiwan
| | - Yin-Kai Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Shan-Chi Yu
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiu-Po Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Huei Tseng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Lee SQW, Azhar R, Goh BKP. An Unusual Cause of an Arterial Enhancing Liver Mass. Gastroenterology 2017; 152:e5-e6. [PMID: 28273435 DOI: 10.1053/j.gastro.2016.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/17/2016] [Accepted: 09/05/2016] [Indexed: 12/02/2022]
Affiliation(s)
- Shaun Q W Lee
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore
| | - Rafay Azhar
- Department of Pathology, Singapore General Hospital, Singapore
| | - Brian K P Goh
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore; Duke-National University of Singapore Medical School, Singapore
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17
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Hu HJ, Qu YJ, Tian ZX, Zhang ZP. Clinical and radiographic observations from four patients with primary hepatic lymphoma. Exp Ther Med 2015; 11:381-386. [PMID: 26893619 PMCID: PMC4734166 DOI: 10.3892/etm.2015.2940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 02/23/2015] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to delineate the radiographic and clinical features of primary hepatic lymphoma (PHL). Four histopathologically confirmed cases of PHL were analyzed with respect to the radiological, clinical and pathological characteristics. The main clinical manifestations included upper right quadrant pain and lymphoma-associated B symptoms, such as fever, night sweating and weight loss. All the patients had elevated serum levels of lactate dehydrogenase. Furthermore, all the patients underwent plain and enhanced computed tomography examinations, which identified low-density lesions without marked enhancement. Solitary masses were observed in two cases, while multiple focal lesions were noted in one case and diffuse multi-speckled nodules were observed in one case. Two patients underwent abdominal magnetic resonance imaging, which revealed lesions that were hyperintense on T1-weighted imaging (WI) scans and hypointense on T2WI scans, and exhibited slight to moderate enhancement with a dynamic contrast-enhanced protocol. In one case, vessels were visible within the lesion. Therefore, the present study concluded that PHL is a rare condition that exhibits non-specific clinical and radiological features. A combination of imaging results and clinical manifestations can be used to facilitate a diagnosis of PHL.
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Affiliation(s)
- Hui-Juan Hu
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Yan-Juan Qu
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Zhi-Xiong Tian
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
| | - Zai-Peng Zhang
- Department of Computed Tomography, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
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Nagral A, Jhaveri A, Kalthoonical V, Bhat G, Mahajan P, Borges A. Primary Liver Sinusoidal Non-Hodgkin's Lymphoma Presenting as Acute Liver Failure. J Clin Exp Hepatol 2015; 5:341-3. [PMID: 26900276 PMCID: PMC4723650 DOI: 10.1016/j.jceh.2015.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/26/2015] [Indexed: 12/12/2022] Open
Abstract
We describe a case of a middle-aged woman, who presented to us with fever, anorexia, abdominal distension from a massive hepatomegaly, low hemoglobin, and acute liver failure. A liver biopsy revealed B cell non-Hodgkin's lymphoma predominantly in the sinusoids with CD10, CD20, and Bcl-2 positive on immunohistochemistry. She initially responded well to chemotherapy but succumbed 6 months later to the recurrence of disease. Sinusoidal non-Hodgkin's lymphoma of the liver should be considered in the differential diagnosis of a patient with large hepatomegaly presenting with acute liver failure.
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Key Words
- AFP, alpha feto protein
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- B cell
- Bcl 2, B cell lymphoma 2
- CD, cluster differentiation
- CECT, contrast enhanced computed tomography
- CHOP, cyclophosphamide hydroxydaunorubicin (adriyamycin) oncovin (vincristine) prednisolone
- CK, cyto keratin
- HBsAg, hepatitis B surface antigen
- HCV, hepatitis C virus
- HIV, human immunodeficiency virus
- IgM, immunoglobulin M
- NHL, non-Hodgkins lymphoma
- PET CT, positron emission tomography–computed tomography
- WBC, white blood cells
- chemotherapy
- hepatocyte
- liver failure
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Affiliation(s)
- Aabha Nagral
- Department of Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, India,Address for correspondence: 7, Sneh Sagar, Second Floor, Prabha Nagar Society, Prabhadevi, Mumbai 400025, India.
| | - Ajay Jhaveri
- Department of Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, India
| | - Vilesh Kalthoonical
- Department of Nephrology, Jaslok Hospital and Research Centre, Mumbai, India
| | - Ganapathi Bhat
- Department of Medical Oncology, Jaslok Hospital and Research Centre, Mumbai, India
| | - Pravin Mahajan
- Department of Histopathology, S. L. Raheja Hospital, Mumbai, India
| | - Anita Borges
- Department of Histopathology, S. L. Raheja Hospital, Mumbai, India
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Patel SK, Shera IA. A rare tumor with unusual clinical presentation detected by positron emission tomography-computed tomography. Indian J Nucl Med 2015; 30:331-3. [PMID: 26430318 PMCID: PMC4579619 DOI: 10.4103/0972-3919.164024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Primary hepatic lymphoma represents <1% of extranodal lymphoma and predominantly seen in men older than 50 years of age. Exact etiology for these tumors is not certain yet, but presumed to be caused by certain viruses like Epstein-Barr virus and hepatitis C virus due to the frequent association of these viruses with disease. Most of these tumors are diffuse large B cell non-Hodgkin lymphoma. Direct tissue histopathology with immunochemistry may give clues about diagnosis and prognosis up to certain extent. The rituximab-based chemotherapy is the mainstay of therapy for these tumors; the role of radiotherapy is still not clear but used for management for bulky tumors.
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Affiliation(s)
- Sitendu Kumar Patel
- Department of Gastroenterology, Max Super Speciality Hospital, New Delhi, India
| | - Irfan Ali Shera
- Department of Gastroenterology, Max Super Speciality Hospital, New Delhi, India
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Abe H, Kamimura K, Kawai H, Kamimura H, Domori K, Kobayashi Y, Nomoto M, Aoyagi Y. Diagnostic imaging of hepatic lymphoma. Clin Res Hepatol Gastroenterol 2015; 39:435-42. [PMID: 25541481 DOI: 10.1016/j.clinre.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/10/2014] [Accepted: 11/03/2014] [Indexed: 02/06/2023]
Abstract
Hepatic lymphoma is a rare disease with poor prognosis because of delayed diagnosis. The disease comprises primary, metastatic, and intravascular hepatic lymphomas. The pathological characteristics of lymphomas differ contributing to difficulty in early diagnosis. Early diagnosis and appropriate treatment result in improved prognosis; therefore, diagnostic radiology and its development with various contrast agents are critical for improving disease outcomes. Herein, we review hepatic lymphomas and summarize the results of imaging studies in correlation with pathological characteristics. The information provided will help physicians in early diagnosis and thereby improving prognosis.
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Affiliation(s)
- Hiroyuki Abe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan.
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Koji Domori
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Yuji Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Minoru Nomoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
| | - Yutaka Aoyagi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, 951-8510, Japan
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Abstract
Primary non-Hodgkin lymphoma of the liver is a very rare malignancy. In this case report, we describe a case of primary hepatic lymphoma (PHL) in a 60-year-old man who presented with lump and pain in the abdomen of 2 months’ duration. The patient had altered liver function, normal serum alfa fetoprotein level (AFP), normal hemogram and bone marrow. A computed tomography scan of the abdomen and pelvis showed an ill-defined hypodense mass with specks of calcification involving the liver, suggestive of primary malignant mass of liver. Diagnosis of PHL was established on the cytology smear and confirmed by immunohistochemistry on tissue biopsy. This case demonstrates that PHL should be considered in the differential diagnosis of space-occupying liver lesions in the presence of a normal level of AFP. Fine needle aspiration cytology is a faster and safer diagnostic modality even in such a rare case. The case has many unique features like negative serology for viruses, no type B symptom and normal lactate dehydrogenase level.
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Affiliation(s)
- Trupti S Patel
- Department of Pathology, MP Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmadabad, Gujarat, India
| | - Rujuta Malvania
- Department of Pathology, MP Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmadabad, Gujarat, India
| | - Majal C Shah
- Department of Pathology, MP Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmadabad, Gujarat, India
| | - Manoj J Shah
- Department of Pathology, MP Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmadabad, Gujarat, India
| | - Amisha G Gami
- Department of Pathology, MP Shah Cancer Hospital, Gujarat Cancer and Research Institute, Ahmadabad, Gujarat, India
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Dhamija E, Madhusudhan KS, Shalimar, Das P, Srivastava DN, Gupta AK. Primary Hepatic Diffuse Large B-Cell Lymphoma: Unusual Presentation and Imaging Features. Curr Probl Diagn Radiol 2015; 44:290-293. [DOI: 10.1067/j.cpradiol.2014.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Pedrassa BC, da Rocha EL, Kierzenbaum ML, Bormann RL, Francisc VV, D'Ippolito G. Uncommon hepatic tumors: iconographic essay - Part 2. Radiol Bras 2015; 47:374-9. [PMID: 25741121 PMCID: PMC4341376 DOI: 10.1590/0100-3984.2013.1761] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 10/14/2013] [Indexed: 12/16/2022] Open
Abstract
In cases where typical aspects are shown, the diagnosis of most frequent hepatic lesions can be made with some safety by means of several imaging methods; on the other hand, uncommon lesions generally represent a diagnostic challenge for the radiologist. In the present second part of the study, the authors describe four rare hepatic lesions, as follows: primary hepatic lymphoma, myofibroblastic tumor, primary hepatic neuroendocrine tumor and desmoplastic small round cell tumor, approaching their main characteristics and imaging findings with emphasis on computed tomography and magnetic resonance imaging.
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Affiliation(s)
- Bruno Cheregati Pedrassa
- MDs, Radiologists, Fellows at Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Eduardo Lima da Rocha
- MDs, Radiologists, Fellows at Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Marcelo Longo Kierzenbaum
- MDs, Radiologists, Fellows at Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Renata Lilian Bormann
- MDs, Radiologists, Fellows at Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Viviane Vieira Francisc
- PhD, MD, Radiologist, Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
| | - Giuseppe D'Ippolito
- Associate Professor, Department of Imaging Diagnosis, Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil
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Shiozawa K, Watanabe M, Ikehara T, Matsukiyo Y, Kikuchi Y, Kaneko H, Okubo Y, Shibuya K, Igarashi Y, Sumino Y. A case of contiguous primary hepatic marginal zone B-cell lymphoma and hemangioma ultimately diagnosed using contrast-enhanced ultrasonography. Case Rep Oncol 2015; 8:50-6. [PMID: 25848352 PMCID: PMC4361915 DOI: 10.1159/000375118] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Primary hepatic marginal zone B-cell malignant lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare. We present a case in which a lesion was diagnosed as 2 contiguous tumors (MALT lymphoma and hemangioma) using contrast-enhanced ultrasonography (US) with sonazoid. There has been no previous case of contiguous hepatic MALT lymphoma and hemangioma. The present case was a female with no medical history. We detected a snowman-like appearance, which was a tumor of 15 mm in diameter with hypo- and hyper-echogenicities in the lateral and medial parts, respectively, in the Couinaud's segment (S6) of the liver on US. The tumor appeared as a single lesion with a low-density area in the unenhanced phase and prolonged enhancement in the equilibrium phases on dynamic CT. On MRI, the whole lesion showed a low-intensity signal on T1-weighted imaging, but isointensity in the lateral part and high intensity in the medial part were seen on T2-weighted imaging. On contrast-enhanced US, the lateral hypoechoic region was homogenously hyperenhanced in the early vascular phase, and the contrast medium was washed out after about 30 s; in contrast, the medial hyperechoic region was gradually stained from the margin toward the central region. The tumor showed a defect in both hypo- and hyperechoic regions in the postvascular phase. Hemangioma was suspected for the medial part based on the typical image findings, but the lateral part was not given a diagnosis. Thus, surgical resection was performed. The medial part was a hemangioma, and the lateral part was a MALT lymphoma by histopathological findings.
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Affiliation(s)
- Kazue Shiozawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Manabu Watanabe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Takashi Ikehara
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Yasushi Matsukiyo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Yoshinori Kikuchi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Hironori Kaneko
- Division of Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, Tokyo, Japan
| | - Yoichiro Okubo
- Department of Surgical Pathology, Toho University Medical Center, Omori Hospital, Tokyo, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Medical Center, Omori Hospital, Tokyo, Japan
| | - Yoshinori Igarashi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
| | - Yasukiyo Sumino
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan
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Zhang KJ, Chen S, Chen JL, Dong LH. Complete response to comprehensive treatment of a primary hepatic diffuse large B cell lymphoma: A case report. Oncol Lett 2015; 9:1557-1560. [PMID: 25789000 PMCID: PMC4356420 DOI: 10.3892/ol.2015.2920] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 12/16/2014] [Indexed: 01/20/2023] Open
Abstract
Primary hepatic lymphoma (PHL) is an uncommon lymphoid tumor with varied clinical features and treatment outcome. In the present study, the case of a 56-year-old patient with PHL and no clinical presentation was reported. During a routine physical examination, multiple hypodense nodules were incidentally detected in right lobes of the liver and hepatic portal in an abdominal computed tomography scan. A liver biopsy revealed the presence of a non-Hodgkin's lymphoma diffuse large B cell type that was CD20-positive, followed by the diagnosis of a PHL. The patient was treated with R-CHOP, radiotherapy and R-Hyper-CVAD/R-HD MTX-ara-C, and complete remission was achieved.
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Affiliation(s)
- Kai Jing Zhang
- Department of Hematology, Taizhou Central Hospital, Taizhou, Zhejiang 380000, P.R. China
| | - Sai Chen
- Department of Hematology, Taizhou Central Hospital, Taizhou, Zhejiang 380000, P.R. China
| | - Jian Lin Chen
- Department of Hematology, Taizhou Central Hospital, Taizhou, Zhejiang 380000, P.R. China
| | - Li Hua Dong
- Department of Hematology, Henan Provincial Tumor Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China
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27
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Wu GB, Huang CY, Huang S, Ru HM, Xiang BDE, Yuan WP, Wu FX, Liu JY, Zhang ZM, Ma L, Chen ZS, Zhao YN, Li LEQ. Primary hepatic non-Hodgkin's lymphoma with rectal cancer: A case report. Oncol Lett 2014; 9:324-326. [PMID: 25435985 PMCID: PMC4247066 DOI: 10.3892/ol.2014.2673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 10/15/2014] [Indexed: 12/03/2022] Open
Abstract
Primary hepatic non-Hodgkin’s lymphoma (NHL) is an extremely rare disease that is commonly neglected as a possible diagnosis. The present study reports the case of a middle-aged male with chronic hepatitis B in which primary hepatic NHL and rectal cancer occurred simultaneously. A large solitary tumor in the left lobe of the liver was incidentally detected on routine examination prior to the laparoscopic resection of the rectal cancer. Laparoscopic resection of the rectal cancer and a liver biopsy were performed simultaneously. The pathology revealed that the hepatic tumor was NHL and that the rectal cancer was adenocarcinoma. Systemic staging revealed no evidence of nodal or bone marrow involvement, therefore, primary hepatic lymphoma (PHL) was diagnosed. PHL associated with rectal adenocarcinoma is extremely rare and to the best of our knowledge, has never been reported. At present, the cause and most effective therapy for the condition remain unclear.
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Affiliation(s)
- Guo-Bin Wu
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Chao-Yuan Huang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Shan Huang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Hai-Ming Ru
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Bang-DE Xiang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Wei-Ping Yuan
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Fei-Xiang Wu
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jian-Yong Liu
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zhi-Ming Zhang
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Liang Ma
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Zu-Shun Chen
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Yin-Nong Zhao
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - LE-Qun Li
- Department of Hepatobiliary Surgery, Affiliated Tumor Hospital and Oncology School of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Primary hepatic lymphoma: a challenging diagnosis. Case Rep Oncol Med 2014; 2014:212598. [PMID: 24949208 PMCID: PMC4037615 DOI: 10.1155/2014/212598] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 04/28/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Primary hepatic lymphoma is an unusual malignancy and is very difficult to diagnose promptly. An intrigue case presenting with cholestatic jaundice is reviewed and main disease characteristics are further discussed. Case Report. A 70-year-old male presented with dull right upper quadrant abdominal pain and mild cholestatic jaundice. Initial evaluation revealed mildly elevated liver function tests and normal tumor markers, while imaging with an abdominal CT-scan showed multiple hypodense nodules in both liver lobes. First impression of metastatic deposits from gastrointestinal origin was not confirmed by endoscopic means. After CT-guided biopsy, primary diffuse large B-cells non-Hodgkin lymphoma was revealed. Appropriate chemotherapy improved patient's condition markedly. Discussion. Primary hepatic lymphoma is a rare form of extranodal lymphomas, accounting for less than 1% of all extranodal lymphomas in general. In order to define the condition as PHL, liver has to be the only site of lymphoma occurrence or to be involved in a major degree with minimal nonliver disease. Most PHLs are of B-cell origin with large cells as the main cell type.
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Resende V, Oliveira TS, Gomes RT, Laboissière RS, Tavares-Junior WC, de Melo Couto OF. Primary hepatic lymphoma: A case report. Int J Surg Case Rep 2013; 4:1165-8. [PMID: 24200545 PMCID: PMC3860023 DOI: 10.1016/j.ijscr.2013.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 10/03/2013] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Primary hepatic lymphoma is a rare malignancy which misdiagnosis and mistreatment is very frequent. Differential diagnosis of the hepatic lesion, based on the noninvolvement of blood vessels, includes: fatty infiltration, cirrhosis, amyloid infiltration, primary hepatomas, and metastatic neoplasms. PRESENTATION OF CASE We describe a case of a 69-year-old man who presented with 15% weight loss and general fatigue over the previous 9 months. Physical examination revealed hepatomegaly without lymphadenopathy or splenomegaly. Magnetic resonance imaging showed a 13 cm × 9 cm × 11 cm tumor on the right liver associated with normal levels of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA). After two negatives ultrasonography-guided needle liver biopsies, the third one showed diffuse infiltration of large sized lymphoid cells. Immunohistochemical findings demonstrated the B-lymphocyte lineage of the tumor. The patient received R-CHOP therapy (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab) with good response. DISCUSSION It is important to recognize PHL because it responds favorably to chemotherapy and may have a better prognosis than hepatocellular carcinoma or metastatic disease of the liver. When imaging findings on CT scans and MRI are nonspecific, a biopsy is needed not only for a definitive diagnosis but also for identifying the immunophenotype of the PHL. This type of lesion is highly chemosensitive and early aggressive chemotherapy may result in sustained remission. CONCLUSION This case emphasizes the importance of effective recognition of PHL considering its good response to chemotherapy and the possibility of sustained remission if early aggressive treatment is implemented.
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Affiliation(s)
- Vivian Resende
- Department of Surgery, School of Medicine, The Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Mastoraki A, Stefanou MI, Chatzoglou E, Danias N, Kyriazi M, Arkadopoulos N, Smyrniotis V. Primary hepatic lymphoma: dilemmas in diagnostic approach and therapeutic management. Indian J Hematol Blood Transfus 2013; 30:150-4. [PMID: 25114399 DOI: 10.1007/s12288-013-0263-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 04/19/2013] [Indexed: 02/05/2023] Open
Abstract
Primary hepatic lymphoma (PHL) is a very rare malignancy and is characterized by liver involvement at presentation with no affectation of the spleen, lymph nodes, peripheral blood, bone marrow, or other tissues until at least 6 months after diagnosis. PHL should be considered in the differential diagnosis in a patient with space-occupying liver lesions and normal levels of alpha-fetoprotein and CEA. A computed tomography (CT) scan is the commonly used modality for staging lymphomas. The widespread use of positron emission tomography/CT results in the improvement in the accuracy of detecting the extent of disease, response evaluation, and prognostication. The liver biopsy, due to its pleomorphic appearances in the needle biopsy specimen, can be very challenging. Current literature favors the combination of chemotherapy as the frontline treatment for its least invasiveness and improved survival. Favorable prognosis of PHL can be obtained by early surgery combined with chemotherapy in strictly selected patients. However, the optimal therapy is still unclear and the outcomes are uncertain.
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Affiliation(s)
- Aikaterini Mastoraki
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece ; Gr. Lambraki 112-114, Piraeus, Athens, Greece
| | - Maria Ioanna Stefanou
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
| | - Evangelos Chatzoglou
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
| | - Nikolaos Danias
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
| | - Maria Kyriazi
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
| | - Nikolaos Arkadopoulos
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
| | - Vasilios Smyrniotis
- 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece
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Murakami J, Shimizu Y. Hepatic manifestations in hematological disorders. Int J Hepatol 2013; 2013:484903. [PMID: 23606974 PMCID: PMC3626309 DOI: 10.1155/2013/484903] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 02/11/2013] [Accepted: 02/11/2013] [Indexed: 12/17/2022] Open
Abstract
Liver involvement is often observed in several hematological disorders, resulting in abnormal liver function tests, abnormalities in liver imaging studies, or clinical symptoms presenting with hepatic manifestations. In hemolytic anemia, jaundice and hepatosplenomegaly are often seen mimicking liver diseases. In hematologic malignancies, malignant cells often infiltrate the liver and may demonstrate abnormal liver function test results accompanied by hepatosplenomegaly or formation of multiple nodules in the liver and/or spleen. These cases may further evolve into fulminant hepatic failure.
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Affiliation(s)
- Jun Murakami
- The Third Department of Internal Medicine, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan
| | - Yukihiro Shimizu
- Gastroenterology Unit, Takaoka City Hospital, Toyama 933-8550, Japan
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Valladolid G, Adams LL, Weisenberg E, Maker VK, Maker AV. Primary hepatic lymphoma presenting as an isolated solitary hepatic cyst. J Clin Oncol 2012; 31:e21-3. [PMID: 23169506 DOI: 10.1200/jco.2012.44.9728] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Genaro Valladolid
- Creticos Cancer Center at Advocate Illinois Masonic Medical Center, Chicago, IL, USA
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Modruz N, El Mouhadi S, Arrivé L. Liver lymphoma. Clin Res Hepatol Gastroenterol 2012; 36:397-8. [PMID: 22341908 DOI: 10.1016/j.clinre.2012.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 01/04/2012] [Indexed: 02/04/2023]
Affiliation(s)
- N Modruz
- Department of radiology, faculté de médecine Pierre-et-Marie-Curie, université Paris VI, Hospital Saint-Antoine, AP-HP, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France
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Yu YD, Kim DS, Byun GY, Lee JH, Kim IS, Kim CY, Kim YC, Suh SO. Primary hepatic marginal zone B cell lymphoma : a case report and review of the literature. Indian J Surg 2012; 75:331-6. [PMID: 24426608 DOI: 10.1007/s12262-012-0695-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 06/28/2012] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Primary hepatic lymphoma (PHL) is a very rare malignancy, and constitutes about 0.016 % of all cases of non-Hodgkin's lymphoma and is often misdiagnosed. The optimal therapy is still unclear and the outcomes are uncertain. Among PHLs, a primary hepatic low-grade marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare. METHODS We present a case of primary hepatic lymphoma (MALT lymphoma) treated with surgical resection and adjuvant chemotherapy. A 38-year-old Korean man, who was diagnosed with chronic hepatitis B 20 years ago, was admitted for liver biopsy after liver lesions were detected on follow-up computed tomography scan (CT). Liver biopsy revealed the diagnosis of marginal zone B-cell malignant lymphoma (MALT lymphoma). The preoperative clinical staging was IE, given that no additional foci of lymphoma were found anywhere else in the body. The patient underwent left hemihepatectomy. Subsequently, the patient received two cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) regimen. RESULTS After 15 months of follow-up, the patient is alive and well without any evidence of disease recurrence. CONCLUSION Although the prognosis is variable, good response to early surgery combined with postoperative chemotherapy can be achieved in strictly selected patients.
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Affiliation(s)
- Young-Dong Yu
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Dong-Sik Kim
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea ; Department of Surgery, Division of Hepatobiliary and Pancreas Surgery, Korea University Medical Center, Korea University Medical College, Seoul, Korea
| | - Geon-Young Byun
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Jeong-Hyeon Lee
- Department of Pathology, Korea University Medical Center, Korea University Medical College, Seoul, Korea
| | - In-Sun Kim
- Department of Pathology, Korea University Medical Center, Korea University Medical College, Seoul, Korea
| | - Chung-Yun Kim
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Young-Chul Kim
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
| | - Sung-Ock Suh
- Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea
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Kikuma K, Watanabe J, Oshiro Y, Shimogama T, Honda Y, Okamura S, Higaki K, Uike N, Soda T, Momosaki S, Yokota T, Toyoshima S, Takeshita M. Etiological factors in primary hepatic B-cell lymphoma. Virchows Arch 2012; 460:379-87. [PMID: 22395482 PMCID: PMC3320708 DOI: 10.1007/s00428-012-1199-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 01/08/2012] [Accepted: 01/19/2012] [Indexed: 12/26/2022]
Abstract
Sixty-four cases of malignant lymphoma involving the liver were examined. Of these, 20 cases were histologically confirmed to be primary hepatic B-cell lymphoma. Twelve of these 20 cases were diffuse large B-cell lymphoma (DLBCL) and eight cases were mucosa-associated lymphoid tissue (MALT) lymphoma. Of the 12 cases of DLBCL, six were immunohistologically positive for CD10 and/or Bcl6 (indicating a germinal center phenotype), six were positive for Bcl2, and five were positive for CD25. Eight of the 12 DLBCL cases (66.7%) and two of the eight MALT lymphoma cases (25%) had serum anti-hepatitis C virus (HCV) antibodies and HCV RNA. The incidence of HCV infection was significantly higher in the hepatic DLBCL cases than in systemic intravascular large B-cell cases with liver involvement (one of 11 cases, 9.1%) and T/NK-cell lymphoma cases (one of 19 cases, 5.3%) (p < 0.01 for both). Two hepatic DLBCL cases (16.7%) had rheumatoid arthritis treated with methotrexate, and four MALT lymphoma cases (50%) had Sjögren’s syndrome, primary biliary cirrhosis, or autoimmune hepatitis; one case in each of these two groups was complicated by chronic HCV-seropositive hepatitis. Although primary hepatic lymphoma is rare, persistent inflammatory processes associated with HCV infection or autoimmune disease may play independent roles in the lymphomagenesis of hepatic B cells.
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Affiliation(s)
- Kanta Kikuma
- Departments of Pathology and Internal Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7-45-1, Johnan-ku, Fukuoka, Japan
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Primary hepatic lymphoma in a patient with previous rectal adenocarcinoma: a case report and discussion of etiopathogenesis and diagnostic tools. Int J Hematol 2012; 95:320-3. [DOI: 10.1007/s12185-012-1025-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Revised: 01/31/2012] [Accepted: 01/31/2012] [Indexed: 02/01/2023]
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Abstract
Malignant and nonmalignant disorders may affect the liver, causing signs and symptoms ranging from mild increases of liver tests to fulminant hepatic failure. This article discusses the most common hematologic and oncologic disorders and their effect on the liver. The section on nonmalignant hematologic disorders includes the anemias, paroxysmal nocturnal hemoglobinuria, disseminated intravascular coagulation, malaria, Banti syndrome, the porphyrias, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome. Malignant hematologic conditions include leukemias, lymphomas, and myeloproliferative disorders. Other conditions causing portal hypertension and hepatic metastases are also discussed. The most commonly encountered hepatic manifestations of hematologic and oncologic disorders are reviewed.
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Affiliation(s)
- Marvin M Singh
- Division of Gastroenterology and Hepatology, Scripps Clinic Torrey Pines, and The Scripps Research Institute, 10666 North Torrey Pines Road, N 203 La Jolla, CA 92037, USA
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Hayashi M, Yonetani N, Hirokawa F, Asakuma M, Miyaji K, Takeshita A, Yamamoto K, Haga H, Takubo T, Tanigawa N. An operative case of hepatic pseudolymphoma difficult to differentiate from primary hepatic marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. World J Surg Oncol 2011; 9:3. [PMID: 21232116 PMCID: PMC3033353 DOI: 10.1186/1477-7819-9-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 01/13/2011] [Indexed: 12/16/2022] Open
Abstract
Hepatic pseudolymphoma (HPL) and primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) are rare diseases and the differential diagnosis between these two entities is sometimes difficult. We herein report a 56-year-old Japanese woman who was pointed out to have a space occupying lesion in the left lateral segment of the liver. Hepatitis viral-associated antigen/antibody was negative and liver function tests including lactic dehydrogenase, peripheral blood count, tumor markers and soluble interleukin-2 receptor were all within normal limit. Imaging study using computed tomography and magnetic resonance imaging were not typical for hepatocellular carcinoma, cholangiocarcinoma, or other metastatic cancer. Fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning showed high standardized uptake value in the solitary lesion in the liver. Under a diagnosis of primary liver neoplasm, laparoscopic-assisted lateral segmentectomy was performed. Liver tumor of maximal 1.0 cm in diameter was consisted of aggregation of lymphocytes of predominantly B-cell, containing multiple lymphocyte follicles positive for CD10 and bcl-2, consistent with a diagnosis of HPL rather than MALT lymphoma, although a definitive differentiation was pending. The background liver showed non-alcoholic fatty liver disease/early non-alcoholic steatohepatitis. The patient is currently doing well with no sign of relapse 13 months after the surgery. Since the accurate diagnosis is difficult, laparoscopic approach would provide a reasonable procedure of diagnostic and therapeutic advantage with minimal invasiveness for patients. Considering that the real nature of this entity remains unclear, vigilant follow-up of patient is essential.
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Affiliation(s)
- Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
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Kanellopoulou T, Alexopoulou A, Kontopidou FN, Filiotou A. Development of non-Hodgkin's lymphoma in a patient with primary biliary cirrhosis: A case report and review of the literature. Ann Gastroenterol 2011; 24:125-128. [PMID: 24713720 PMCID: PMC3959296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 02/15/2011] [Indexed: 10/31/2022] Open
Abstract
Patients with autoimmune disorders seem to have an elevated risk of lymphoma, especially non-Hodgkin's lymphoma (NHL). The increased risk has been attributed to the disturbance of immune function found in these patients or to the immunosuppressive therapy used to treat the autoimmune disorders. However, little information exists about the estimated baseline risk for lymphoma in patients with primary biliary cirrhosis (PBC). In this case report, we describe a female patient who developed nodal diffuse large B-cell lymphoma ten years following PBC diagnosis. Twenty five additional case reports (19 NHL and 4 Hodgkin's disease (HD), 2 without data about NHL or Hodgkin's disease) predominantly females were identified in the English literature. B-cell lymphoma was the most common NHL type reported but beyond that no clear predisposition for any specific lymphoma subtype was documented. PBC usually preceded lymphoma diagnosis. Fifteen cases had extranodal localization and the most common site was the liver.
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Affiliation(s)
- Theoni Kanellopoulou
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece
| | - Alexandra Alexopoulou
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece,
Correspondence to: Alexandra Alexopoulou, Lecturer in Medicine, 40 Konstantinoupoleos Str, 16342 Athens, Greece; tel. +302107774742; fax: +30 2107706871;
| | - Flora N. Kontopidou
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece
| | - Anna Filiotou
- 2nd Department of Internal Medicine, Medical School, University of Athens, Hippokration General Hospital, Athens, Greece
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Yang XW, Tan WF, Yu WL, Shi S, Wang Y, Zhang YL, Zhang YJ, Wu MC. Diagnosis and surgical treatment of primary hepatic lymphoma. World J Gastroenterol 2010; 16:6016-9. [PMID: 21157979 PMCID: PMC3007103 DOI: 10.3748/wjg.v16.i47.6016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the benefits and limits of surgery for primary hepatic lymphoma (PHL), and probability of survival after postoperative chemotherapy.
METHODS: A retrospective analysis was undertaken to determine the results of surgical treatment of PHL over the past 8 years. Only nine patients underwent such treatment. The detailed data of diagnosis, treatment, and prognosis were carefully studied.
RESULTS: All patients were mistaken as having α-fetoprotein-negative hepatic cancer before pathological diagnosis. The mean delay time between initial symptoms and final diagnosis was 26.8 d (range: 14-47 d). Hepatitis B virus infection was noted in 33.3% of these patients. Most of the lesions were found to be restricted to a solitary hepatic mass. The surgical procedure performed was left hepatectomy in five cases, including left lateral segmentectomy in three. Right hepatectomy was performed in three cases and combined procedures in one. One patient died on the eighth day after surgery, secondary to hepatic insufficiency. The cumulative 6-mo, 1-year, and 2-year survival rates after hepatic surgery were, respectively, 85.7%, 71.4%, and 47.6%. One patient survived for > 5 years after surgery without any signs of recurrence until latest follow-up, who received routine postoperative chemotherapy every month for 2 years and then regular follow-up. By univariate analysis, postoperative chemotherapy was a significant prognostic factor that influenced survival (P = 0.006).
CONCLUSION: PHL is a rare entity that is often misdiagnosed, and has a potential association with chronic hepatitis B infection. The prognosis is variable, with good response to early surgery combined with postoperative chemotherapy in strictly selected patients.
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