Clinical management and susceptibility of primary hepatic lymphoma: A cases-based retrospective study

Abstract

BACKGROUND The liver as a primary site of lymphoma is rarely seen, they are usually misdiagnosed as hepatocellular carcinoma, etc . In 2017, a review of primary hepatic lymphoma (PHL) was done in immunocompetent diffuse large B-cell lymphoma (DLBCL) patients. Yet questions that include treatment choosing or susceptibility of immunoincompetent patients remain disputable. AIM To investigate the clinical characteristics of patients with PHL. METHODS We collected PHL cases on PubMed, and extracted demographic and clinicopathological data to perform a systematic analysis. Survival analysis regarding age, lactate dehydrogenase (LDH), liver function abnormality (LFA), and treatment modalities were conducted. The Kaplan-Meier method and Cox regression were used to identify risk factors. RESULTS Of 116 PHL patients with DLBCL (62.1%) as the most common subtype. Biopsy methods before surgery produced a 97% positive rate. Progression-free survival (PFS) was significantly shortened in patients with elevated LDH [Hazard ratio (HR): 3.076, 95% confidence interval (CI): 1.207-7.840, P = 0.018] or LFA (HR: 2.909, 95%CI: 1.135-7.452, P = 0.026). Univariate Cox regression analysis suggesting that LDH, liver function, B symptom, hepatosplenomegaly, and lesion were significantly associated with PHL patients survival ( P < 0.05). Heavy disease burden was observed in deceased patients. A few PHL patients (3.4%) have slightly higher tumor markers. CONCLUSION PHL patients with elevated LDH and LFA tend to have shorter PFS. Biopsy before treatment in undecided patients with no tumor markers exceeds upper limits has the most essential clinical significance, especially in immunoincompetent patients.

Contrast-enhanced ultrasound findings of primary hepatic non-Hodgkin’s lymphoma: a case report

“…The liver lesion was found by chance, and the cause of the disease may be related to the patient’s autoimmune function ( 10 ). Regarding experimental examination, CEA was negative, AFP was at critical value, AST was increased 2-3 times, and LDH was significantly increased, consistent with previous reports ( 11 ).…”

Primary hepatic mucosa-associated lymphoid tissue lymphoma complicated with atrial fibrillation: A case report and literature review

“…[ 4 ] Common clinical manifestations of primary hepatic MALT lymphoma include right upper abdominal discomfort, nausea or vomiting, general fatigue, lymphoma “B” symptoms (fever, night sweats, weight loss, etc) and enlarged liver can be detected in about 50% of patients on physical examination. [ 5 ] In addition, a small number of patients may have jaundice, thrombocytopenia and other symptoms, [ 6 ] so it is easily confused with hepatocellular carcinoma, intrahepatic bile duct carcinoma, hepatic hemangioma, hepatic metastasis and hepatic abscess in clinical practice. [ 7 ] The first peculiarity of our case is that the patient developed none of these symptoms or signs above.…”

Primary hepatopancreatobiliary lymphoma: Pathogenesis, diagnosis, and management

“…On the physical examination of abdomen, tenderness in the upper right quadrant and hepatomegaly are the common presenting features. Splenomegaly occasionally can be observed in a few cases, as a consequence of hepatic dysfunction and portal hypertension ( 24 , 31 , 34 ).…”