Primary hepatic lymphoma in a patient with cirrhosis: a case report
- PDF / 980,698 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 0 Downloads / 181 Views
(2020) 14:168
CASE REPORT
Open Access
Primary hepatic lymphoma in a patient with cirrhosis: a case report Eduardo Dantas1* , Joana Santos2, Mariana Coelho1, Cristiana Sequeira1, Inês Santos1, Cláudia Cardoso1 and Ana Paula Oliveira1
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. Keywords: Primary hepatic lymphoma, Diffuse large B-cell lymphoma
Introduction Diffuse large B-cell lymphoma (DLBCL) is the most common histological type of non-Hodgkin lymphoma (NHL), being responsible for nearly 30% of NHL cases [1], with an annual incidence in Europe of 3.8 per 100, 000 [2]. Even though the liver contains lymphoid tissue, host factors may make it a poor environment for the development of malignant lymphoma. More often, NHL affects the liver in advanced stages of a systemic disease and rarely as a primary hepatic lymphoma (PHL) [3]. PHL accounts for 0.4% of extranodal NHL and 0.016% of all NHL [4]. The majority of PHLs are B-cell lymphomas, with DLBCL being the most common subtype [5]. Due to its rare occurrence, the pathogenesis of PHL is * Correspondence: [email protected] 1 Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal Full list of author information is available at the end of the article
still unclear. Various etiologic factors have been proposed, including viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and Epstein-Barr virus (EBV), as well as liver cirrhosis, autoimmune disorders, and immunosuppressive therapy, although risk rates in these patients have not been reported so far due to disease rarity [6]. Chronic liver disease before the onset of PHL has been reported in 9.6% of 52 patients in a small case series in Western countries [7]. HCV infection is found in 20– 60% of patients, indicating that it may be involved in the pathogenesis of the disease [8]. Clinical manifestations, laboratory findings, and imaging features are usuall
Data Loading...
