Abstract
Primary non-Hodgkin lymphoma of the liver is a very rare malignancy. Here, we report the case of a 78-year old man who presented with complaints of fatigue, slight weight loss and decreased appetite; since 6 months. Because he was anemic and regularly taking aspirine, we first suspected chronic blood loss from the stomach as a cause of anemia. Gastroduodenoscopy was planned as the next step. It revealed an external hemispheric, mobile compression on the greater curvatura of the stomach; which had to be further evaluated via whole abdominal computed tomography with contrast Abdominal computed tomography demonstrated hepatomegaly caused by multiple mass lesions, with necrosis at the center. Next, a positron-emission tomography was advised; and it revealed potential malignacy with widespread lymph node metastases and malignant ascites. Liver biopsy performed under ultrasonographic guidance revealed diffuse large B-cell lymphoma of the liver. The patient is now under medical oncology follow-up, and receiving chemotherapy. Based on our findings, physicians should be more aware and consider that external gastric compression on routine gastroscopy may be an indicator of a more serious disease.
References
- 1. Caccamo D, Pervez NK, Marchevsky A. Primary lymphoma of the liver in the acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1986; 110 (6): 553-5. 2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972; 29 (1): 252-60. 3. Resende V, Oliveira TS, Gomes RT, Laboissiere RS, Tavares-Junior WC, De Melo Couto OF. Primary hepatic lymphoma: A case report. Int J Surg Case Rep. 2013; 4 (12): 1165-68. 4. Raimondo L, Ferrara I, Stefano AD, Cella CA, D’Armiento FP, Ciancia G, et al. Primary hepatic lymphoma in a patient with previous rectal adenocarcinoma: A case report and discussion of etiopathogenesis and diagnostic tools. Int J Hematol 2012; 95 (3): 320-3. 5. Lei KI. Primary non-Hodgkin’ s lymphoma of the liver. Leuk Lymphoma 1998; 29 (3-4): 293-9. 6. Trneny M, Salkova J, Dlouha J, Stritesky J. Hepatic involvement in patients with non-Hodgkin’ s lymphoma. Vnitr Lek 2013; 59 (7): 606-611. 7. K Kikuma K, Watanabe J, Oshiro Y, Shimoqama T, Honda Y, Okamura S, et al. Etiological factors in primary hepatic B-cell lymphoma. Virchows Arch 2012; 460 (4): 379-387. 8. Ata AA, Kamel IA. Primary reticulum cell sarcoma of the liver: a case report. The Journal of the Egyptian Medical Association 1965. 48 (7). 514-21. 9. Haider FS, Smith R, Khan S. Primary hepatic lymphoma presenting as fulminant hepatic failure with hyperferritinemia: A case report. J Med Case Reports. 2008; 2: 279. 10. Agmon-Levin N, Berger I, Shtalrid M, Schlanger H, Sthoeqer ZM. Primary hepatic lymphoma: a case report and review of the literature. Age Aging 2004; 33 (6): 637-40. 11. Bronowicki JP, Bineau C, Feugier P, Hermine O, Brousse N, Oberti F, et al. Primary lymphoma of the liver: clinical-pathological features and relationship with HCV infection in French patients. Hepatology 2003; 37 (4). 781-7. 12. Masood A, Kairouz S, Hudhud KH, Heqazi AZ, Banu A, Gupta NC. Primary non-Hodgkin lymphoma of the liver. Current Oncology 2009; 16 (4). 74-7. 13. Cameron AM, Truty J, Truell J, Zimmerman MA, Kelly BS Jr, Farmer DG, et al. Fulminant hepatic failure from primary hepatic lymphoma: Successful treatment with orthotopic liver transplantation and chemotherapy. Transplantation. 2005; 80 (7): 993-6. 14. Bauduer F, Marty F, Gemain MC, Dulubac E, Bordahandy R. Primary non-Hodgkin’ s lymphoma of the liver in a patient with hepatitis B, C, HIV infections. Am J Hematol. 1997; 54 (3): 265.
Abstract
Karaciğerin primer non-Hodgkin lenfoması, oldukça nadir görülür. Bu yazıda; son 6 aydır yorgunluk-hafif kilo kaybı-iştahsızlık yakınmaları olan 78 yaşındaki bir erkek hastanın vaka sunumunu yapıyoruz. Hasta anemik olduğu ve düzenli aspirin kullanım öyküsünden dolayı, öncelikle mideden kronik kan kaybı olasılığını düşünerek, bir gastroskopi yapmayı planladık. Gastroskopide; büyük kurvatura üzerinde hareketli, yarım küre şeklinde bir dış bası izi görerek; bir sonraki basamak olarak kontrastlı tüm batın tomografisi çektirdik. Batın tomografisinde; çok sayıda kitle lezyonlarının sebep olduğu, büyümüş bir karaciğer saptandı. Yapılan pozitron emisyon tomografisinde yaygın lenf nodu tutulumu olan, assite sebep olmuş muhtemel bir malignite tespit edildi. Ultrasonografi eşliğinde karaciğer biyopsisi gerçekleştirildi, patolojik tanı karaciğerin yaygın büyük B hücreli lenfoması olarak geldi. Hasta şu anda medikal onkolojinin takibinde olup, kemoterapi seanslarına girmektedir. Umarız ki yazımız, gastroskopi yapan meslektaşlarımızda, işlem sırasında saptanan böyle bir dış basının altından ilginç tanılar çıkabileceğine dair farkındalık yaratır.
References
- 1. Caccamo D, Pervez NK, Marchevsky A. Primary lymphoma of the liver in the acquired immunodeficiency syndrome. Arch Pathol Lab Med. 1986; 110 (6): 553-5. 2. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972; 29 (1): 252-60. 3. Resende V, Oliveira TS, Gomes RT, Laboissiere RS, Tavares-Junior WC, De Melo Couto OF. Primary hepatic lymphoma: A case report. Int J Surg Case Rep. 2013; 4 (12): 1165-68. 4. Raimondo L, Ferrara I, Stefano AD, Cella CA, D’Armiento FP, Ciancia G, et al. Primary hepatic lymphoma in a patient with previous rectal adenocarcinoma: A case report and discussion of etiopathogenesis and diagnostic tools. Int J Hematol 2012; 95 (3): 320-3. 5. Lei KI. Primary non-Hodgkin’ s lymphoma of the liver. Leuk Lymphoma 1998; 29 (3-4): 293-9. 6. Trneny M, Salkova J, Dlouha J, Stritesky J. Hepatic involvement in patients with non-Hodgkin’ s lymphoma. Vnitr Lek 2013; 59 (7): 606-611. 7. K Kikuma K, Watanabe J, Oshiro Y, Shimoqama T, Honda Y, Okamura S, et al. Etiological factors in primary hepatic B-cell lymphoma. Virchows Arch 2012; 460 (4): 379-387. 8. Ata AA, Kamel IA. Primary reticulum cell sarcoma of the liver: a case report. The Journal of the Egyptian Medical Association 1965. 48 (7). 514-21. 9. Haider FS, Smith R, Khan S. Primary hepatic lymphoma presenting as fulminant hepatic failure with hyperferritinemia: A case report. J Med Case Reports. 2008; 2: 279. 10. Agmon-Levin N, Berger I, Shtalrid M, Schlanger H, Sthoeqer ZM. Primary hepatic lymphoma: a case report and review of the literature. Age Aging 2004; 33 (6): 637-40. 11. Bronowicki JP, Bineau C, Feugier P, Hermine O, Brousse N, Oberti F, et al. Primary lymphoma of the liver: clinical-pathological features and relationship with HCV infection in French patients. Hepatology 2003; 37 (4). 781-7. 12. Masood A, Kairouz S, Hudhud KH, Heqazi AZ, Banu A, Gupta NC. Primary non-Hodgkin lymphoma of the liver. Current Oncology 2009; 16 (4). 74-7. 13. Cameron AM, Truty J, Truell J, Zimmerman MA, Kelly BS Jr, Farmer DG, et al. Fulminant hepatic failure from primary hepatic lymphoma: Successful treatment with orthotopic liver transplantation and chemotherapy. Transplantation. 2005; 80 (7): 993-6. 14. Bauduer F, Marty F, Gemain MC, Dulubac E, Bordahandy R. Primary non-Hodgkin’ s lymphoma of the liver in a patient with hepatitis B, C, HIV infections. Am J Hematol. 1997; 54 (3): 265.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | November 23, 2017 |
| Published in Issue | Year 2017 |