Primary Hepatic Non-Hodgkin?s Lymphoma in a Patient with Chronic Hepatitis C: Report of a Case

Kitabayashi, Kazuo; Hasegawa, Taisuke; Ueno, Koichi; Saitô, Hitoshi; Kosaka, Takeo; Takashima, Shigeki; Kurose, Nozomu; Nojima, Takayuki

doi:10.1007/s00595-003-2703-3

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Due to the small number of reported cases, the viability of the optimal treatment for patients with PHL is still debated. Although we believe that chemotherapy is essential after a pathological diagnosis to avoid oversurgery [2], surgery followed by adjuvant chemotherapy is one of the treatment options for patients with localized disease, as carried out in our present case [2,12,18].…”

Section: Discussionmentioning

confidence: 87%

Primary hepatic lymphoma with spindle cell components: a case report

et al. 2006

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Diffuse large B-cell lymphoma (DLBCL) with spindle cell components is extremely rare and often misdiagnosed as carcinoma or sarcoma. Here, we present a case of primary DLBCL with spindle cell components arising in the liver, for which a preoperative diagnosis by needle biopsies was unsuccessful. The patient was a 70-year-old man with a continuous cough. Thoracic computed tomography incidentally detected a mass of 5 cm in diameter in his liver. The initial and second needle biopsies from the liver mass were pathologically diagnosed as suspicious for sarcomatoid hepatocellular carcinoma. He underwent an extended left hepatectomy. Histological examination revealed a diffuse or epithelioid arrangement of round and polygonal cells, mixed with the fascicles of spindle-shaped cells. Immunohistochemically, all the morphological types of tumor cells showed positive reactions for a lymphocytic marker (CD45RB) and B-cell markers (CD20 and CD79a). Double-immunostaining revealed that the spindle-shaped tumor cells expressed CD20, but never expressed alpha-smooth muscle actin. Malignant lymphoma with a spindle cell morphology is quite uncommon, and this variant can be a diagnostic pitfall, especially in tiny biopsy specimens. We emphasize that pathologists should be reminded of lymphoma as a differential diagnosis of spindle cell tumors.

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Section: Discussionmentioning

confidence: 87%

Primary hepatic lymphoma with spindle cell components: a case report

et al. 2006

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“…Only one of the three patients was immune-suppressed, and none presented with signs of chronic hepatopathy. Association of primary hepatic lymphoma with cirrhosis and chronic hepatitis has been described in 30% of cases (12)(13)(14)(15) . Although the reason for this association still remains unclear, the diagnosis of NHL should be considered in cirrhotic patients with voluminous hepatic mass and normal alphafetoprotein levels.…”

Section: Discussionmentioning

confidence: 99%

Linfoma não-Hodgkin apresentando-se como massa hepática única

et al. 2009

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OBJECTIVE: To describe the main imaging findings of non-Hodgkin's lymphoma presenting as a single liver mass. MATERIALS AND METHODS: A retrospective study was developed with analysis of cases where a single liver mass was observed at ultrasonography, computed tomography and magnetic resonance imaging, and histologically diagnosed as non-Hodgkin's lymphoma. The studies were reviewed by two observers in consensus. RESULTS: Three male patients in the fifth decade of life, with non-specific clinical manifestations and single liver mass diagnosed as non-Hodgkin's lymphoma were identified. A hepatic lesion with target sign was observed at ultrasonography in all of the cases. At computed tomography, all the patients presented a heterogeneous, hypodense mass with a ring enhancement. At magnetic resonance imaging, the lesions were heterogeneous and hypointense on T1-weighted and hyperintense on T2-weighted images. Additionally, a ring enhancement was observed in all of the cases after contrast injection. At the moment of the diagnosis, none of the patients presented lymphadenomegaly or involvement of other solid viscera. CONCLUSION: The diagnosis of hepatic lymphoma should be considered in the presence of a ring-enhanced single liver mass. Keywords: Lymphoma; Liver; Ultrasonography; Computed tomography; Magnetic resonance imaging.OBJETIVO: Descrever as principais características de imagem do linfoma não-Hodgkin apresentando-se como massa hepática única. MATERIAIS E MÉTODOS: Realizamos estudo retrospectivo mediante análise de casos de pacientes com massa hepática única aos exames de ultrassonografia, tomografia computadorizada e ressonância magnética, com diagnóstico histológico de linfoma não-Hodgkin. Esses exames foram analisados por dois examinadores em consenso. RESULTADOS: Identificamos três pacientes, todos do sexo masculino, na quinta década de vida, com quadro clínico inespecífico e que apresentavam massa hepática única e com diagnóstico de linfoma não-Hodgkin. Na ultrassonografia a lesão hepática apresentava-se como massa com aspecto "em alvo" nos três casos estudados. Na tomografia computadorizada observou-se massa hipodensa e heterogênea, com realce anelar em todos os casos. Na ressonância magnética as lesões apresentavam-se heterogêneas, hipointensas em T1 e hiperintensas em T2, e também com realce anelar após a injeção do contraste. Nenhum paciente apresentava linfonodomegalia ou comprometimento de outras vísceras sólidas no momento do diagnóstico. CONCLUSÃO: Na presença de massa hepática solitária e com aspecto "em alvo" deve-se considerar, entre as hipóteses, o diagnóstico de linfoma. Unitermos: Linfoma; Fígado; Ultrassonografia; Tomografia computadorizada; Imagem por ressonância magnética. AbstractResumo

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“…Primary non-Hodgkin's lymphoma of the liver is rare, although the number of reported cases in hepatitis C virus (HCV)-infected individuals is increasing [5], with large B-cell lymphoma the usual histologic type. A recent meta-analysis revealed that HCV prevalence in patients with non-Hodgkin's lymphoma was 15%, as opposed to 1.5% in the general population and 2.9% in patients with other hematologic malignancies, implying a causative role of HCV in non-Hodgkin's lymphoma [6].…”

Section: Commentarymentioning

confidence: 99%

AJR Teaching File: Incidental Hepatic Mass

Beaty

Silva

Petris

2008

American Journal of Roentgenology

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An otherwise asymptomatic 62-year-old man with endstage liver disease secondary to hepatitis C presents for routine follow-up and screening to exclude hepatocellular carcinoma (HCC). Radiologic DescriptionContrast-enhanced CT of the abdomen (Figs. 1A and 1B) reveals two hepatic masses with subtle peripheral hypervascularity and central hypovascularity on arterial and portal venous phases, neither of which shows portal venous shunting on the delayed images. In addition, several low-attenuation foci are present in the spleen, the largest measuring up to 1.3 cm. Contrast-enhanced MRI of the abdomen using gadobenate dimeglumine (MultiHance, Bracco) (Figs. 1C and 1D) shows the same arterial and portal venous phases findings as on CT; however, the hepatic lesions show a target-like appearance with delayed central enhancement and a hypointense rim on 1-hour delayed phase imaging. The hepatic and splenic lesions are isointense to normal splenic tissue on the T1-and T2-weighted series. Sonographically guided core biopsy of the posterior right hepatic lobe mass, seen as a well-defined hypoechoic lesion (Fig. 1G), yielded the pathologic diagnosis of large B-cell lymphoma (Fig. 1J). The indeterminate splenic lesions improved after therapy, consistent with lymphomatous deposits.

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Primary Hepatic Non-Hodgkin?s Lymphoma in a Patient with Chronic Hepatitis C: Report of a Case

Cited by 9 publications

References 10 publications

Primary hepatic lymphoma with spindle cell components: a case report

Primary hepatic lymphoma with spindle cell components: a case report

Linfoma não-Hodgkin apresentando-se como massa hepática única

AJR Teaching File: Incidental Hepatic Mass

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