An unusual case of primary hepatic lymphoma with dramatic but unsustained response to bendamustine plus rituximab and literature review

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.

Jaundice may be the only clinical manifestation of primary hepatosplenic diffuse large B-cell lymphoma: a case report and literature review

“…However, with the rapid development of chemotherapy, especially emerging targeted drugs, immunochemotherapy is considered the best treatment option for PHS-DLBCL, but the appropriate chemical protocol has not been established. 18 The R-CHOP regimen was speculated to be the first-line treatment for PHS-DLBCL. 19 Given the rarity of the disease, further studies on the optimal treatment for PHS-DLBCL should be performed.…”