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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Japanese EATL exhibited different histology, cytogenetic findings and HLA status from those of typical type I EATL. The rare incidence of coeliac disease may influence the tumour cell characteristics of EATL and IELs.

Reports on endoscopic treatment for pancreatic necrosis and pancreatic abscess have occasionally been published in recent years. Single treatments using endoscopic transpapillary or transumural drainage were originally used, but these were frequently changed to surgical therapy. In recent years, attempts have been made, such as the use of a combination of transmural and transpapillary approaches, the balloon dilatation of the cystgastrostoma, and a daily endoscopic necrosectomy and saline solution lavage, and the treatment results have thus been improved, even though the number of cases is low. We performed transmural endoscopic ultrasonography (EUS)-guided drainage without a necrosectomy in two cases with pancreatic necrosis and abscess, and treated cases in which a continuous closed lavage using a tube with a large diameter was effective, and we herein report our findings.

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