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Case Reports
. 2022 May 31;14(5):e25547.
doi: 10.7759/cureus.25547. eCollection 2022 May.

Diagnosis of Primary Hepatic Lymphoma in a 55-Year-Old Male Patient Presented With Pain in the Right Hypochondrium: A Very Rare Case

Furqan Ul Haq  1 , Said Amin  1 , Hamza Yunus  1 , Basharat Ullah  1 , Wajid Ali  1
Affiliations
Case Reports

Diagnosis of Primary Hepatic Lymphoma in a 55-Year-Old Male Patient Presented With Pain in the Right Hypochondrium: A Very Rare Case

Furqan Ul Haq et al. Cureus. .

Abstract

Primary hepatic lymphoma (PHL) is a rare subtype of diffuse large B-cell lymphoma (DLBCL). A 55-year-old male patient presented to us with jaundice and right upper quadrant pain. Investigations showed elevated alkaline phosphatase, lactate dehydrogenase, total bilirubin, normal alanine transaminase, and negative viral profile. Sonographic and computed tomographic scans show hepatosplenomegaly with hypodense lesion in liver associated with lymph nodes enlargement in the region of porta hepatis celiac axis, mediastinal and axillary lymphadenopathy. On immunohistochemistry, cells were positive for cluster of differentiation (CD)-19, CD-20, CD-21, c-myelocytomatosis oncogene (c-MYC), B-cell lymphoma 2 (Bcl-2), multiple myeloma oncogene-1 (MUM-1), same as B cell markers so it is diagnosed as PHL. DLBCL especially PHL shall be considered among the differentials of space-occupying lesions of liver. Early diagnosis of primary hepatic lymphoma is not a difficult task if excisional lymph node biopsy is taken following detection on ultrasound or CT scan which will lead to improved treatment, improvement in survival, and cost-effectiveness with good prognostic outcomes.

Keywords: duodenal diffuse large b-cell lymphoma; hepatic cancer; non-hodgkin's lymphoma; primary hepatic lymphoma; r-chop chemotherapy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Hypodense lesion of 18x16 mm in segment 8 of liver as primary hepatic lymphoma (contrast in arterial phase).
Figure 2
Figure 2. Hypodense lesion of 18x16 mm in segment 8 of liver as primary hepatic lymphoma (contrast in venous phase).
Figure 3
Figure 3. Multiple axillary lymph nodes in the left axillary region (arrow).
Figure 4
Figure 4. Mediastinal lymphadenopathy on chest CT scan (arrow).
Figure 5
Figure 5. Gross sub-hepatic lymph nodes biopsy specimen received through excisional biopsy.
Figure 6
Figure 6. Low magnified LM specimen of lymph node of DLBCL.
The image is showing diffuse infiltration of malignant lymphoid cells with disorganization of typical nodal architecture. In the upper left segment of the specimen, the tumor has invaded outside the capsule to soft tissues. DBCL: diffuse large B-cell lymphoma; LM: light microscopy
Figure 7
Figure 7. Magnified image of specimen showing diffuse large B-cell lymphoma.
The image is showing nests of large to medium-sized neoplastic B cells having large nuclei (as compared to histiocytes and small lymphocytes), high nuclear-cytoplasmic (N/C) ratio, and having highly basophilic stained cytoplasm. These nests of cells are separated by a fibrillary matrix of stroma.
Figure 8
Figure 8. Bcl-6 stained diffuse large B-cell lymphoma (DLBCL) slide.
Bcl: B-cell lymphoma
Figure 9
Figure 9. CD-20 stained diffuse large B-cell lymphoma (DLBCL) slide.
CD: cluster of differentiation
See this image and copyright information in PMC

References

    1. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Swerdlow SH, Campo E, Pileri SA, et al. Blood. 2016;127:2375–2390. - PMC - PubMed
    1. Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: analysis of 1,085 WHO classified cases in a single institution in China. Shi Y, Han Y, Yang J, et al. Chin J Cancer Res. 2019;31:152–161. - PMC - PubMed
    1. Primary diffuse large B-cell lymphoma of the liver in a patient with Sjogren syndrome. Gorodetskiy V, Klapper W, Probatova N, Vasilyev V. Case Rep Oncol Med. 2016;2016 - PMC - PubMed
    1. Sapkota S, Shaikh H. StatPearls [Internet] Treasure Island, FL: StatPearls Publishing; 2022. Non-Hodgkin lymphoma. - PubMed
    1. Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine. Sun R, Medeiros LJ, Young KH. Mod Pathol. 2016;29:1118–1142. - PubMed

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