Longlasting remission of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma achieved by radiotherapy alone

Abstract

Primary hepatic lymphoma is a rare disorder representing less than 1% of all extranodal lymphomas. Histological examination of a primary hepatic lymphoma usually reveals a diffuse large B-cell lymphoma; there have been few reports of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphomas. A 67-year-old man was being treated for a duodenal ulcer; while receiving therapy for the ulcer, a liver mass was incidentally found on abdominal ultrasonography. The pathologic diagnosis of the hepatic mass was an extranodal marginal zone B-cell lymphoma of MALT. The patient underwent radiotherapy with a total of 4,140 cGy delivered. The patient achieved complete remission and has been followed for 6 years with no recurrence of the disease. This report reviews the case of a primary hepatic extranodal marginal zone B-cell lymphoma of MALT successfully treated by radiotherapy alone.

Figure 1

The initial liver MRI showing a 5.7×4.8 cm-sized well defined round solid mass (arrow) in the right lobe, segment 5 (T2 weighted axial images).

Figure 2

Medium power view showing dense sheet-like infiltration of small lymphoid cells (H&E stain, ×100).

Figure 3

Immunohistochemical staining for CD20 showing diffuse membranous staining of the tumor cells (×200).

Figure 4

Immunohistochemical staining for Ki-67 showing several scattered cells with positive nuclear Staining (×200).

Figure 5

Immunohistochemical staining for CD5 showing dense membranous staining of the scattered T-cell (×200).

Figure 6

Immunohistochemical staining for CD23 showing scattered aggregates of follicular dendritic cells (×100).

Figure 7

The follow-up liver MRI (5 years after radiotherapy) showed fibrous contrst radiation changes in the right lobe of the liver. No evidence of tumor recurrence in the liver parenchyma (T2 weighted axial images).