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

Abstract

A 64-year old Chinese male patient was admitted to our hospital because of severe jaundice that persisted for 2 months. No swollen lymph nodes or hepatosplenomegaly was detected on physical examination. His laboratory data indicated high levels of direct bilirubin, alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase. No abnormality was revealed on abdominal computed tomography (CT). However, positron emission tomography (PET)-CT revealed diffuse hypermetabolism in the liver and spleen. Ultimately, liver biopsy guided by PET-CT was performed, revealing that atypical lymphocytes diffusely infiltrated the liver. The immunohistochemical analysis demonstrated that the tumor cells were positive for CD20, Bcl-2, Bcl-6, MUM1, and c-Myc but negative for CD3, CD4, CD8, and CD10. Based on these findings, this patient was diagnosed with primary hepatosplenic diffuse large B-cell lymphoma. After the definite diagnosis, he received chemotherapy and remained in good health as of September 2019.

Diffuse large B-cell lymphoma presenting as reversible intrapulmonary arteriovenous shunts with hypoxia, fever and progressive jaundice: a case report and literature review

“…Primary splenic lymphoma is rare with a reported incidence of less than 1% while primary hepatic lymphoma is 0.4% of all extra-nodal NHL [ 10 , 11 ]. Jaundice can be the only clinical manifestation of primary hepatosplenic DLBCL in a case report [ 12 ]. As progressive jaundice and developed splenomegaly in this patient, we finally conducted spleen biopsy and verified the involvement of the spleen.…”

Primary hepatic lymphoma a case report and literature review

“…However, a small number of patients may experience abdominal pain, fever, jaundice, nausea, poor appetite, and night sweats. [11–13] In the case of the patient described here, an elderly male, the liver mass was discovered during an evaluation for abnormal urination. There were no specific symptoms present.…”

B-cell hepatosplenic lymphoma presenting in adult patient after spontaneous splenic rupture followed by severe persistent hypoglycaemia: type B lactic acidosis and acute liver failure

“…Almost all cases are derived from γδ T cells. B-cell hepatosplenic lymphoma (BCHSL) is strikingly rare, with only a handful of published cases 11. Splenic rupture is an unusual presenting sign of lymphoma—we only located 29 reported cases12–41 (online supplemental table 1).…”

“…B-cell hepatosplenic lymphoma (BCHSL) is strikingly rare, with only a handful of published cases. 11 Splenic rupture is an unusual presenting sign of lymphoma—we only located 29 reported cases 12–41 ( online supplemental table 1 ). Given the rarity of BCHSL, it is not surprising that our case is the first report of this lymphoma presenting with splenic rupture and subsequently the Warburg effect.…”