An Unusual Presentation of Primary Hepatic Diffuse Large B-cell Lymphoma of the Liver

Abstract

This report describes a case of primary hepatic diffuse large B-cell lymphoma (DLBCL) in a 64-year-old male who presented with constitutional symptoms, jaundice, abdominal swelling, and right upper quadrant pain. The diagnosis was confirmed on percutaneous liver biopsy. Notably, there was no evidence of extra-hepatic involvement. The patient received methylprednisolone and cyclophosphamide with good response but was lost to follow-up upon being transferred. This case highlights the importance of considering primary hepatic DLBCL in patients with unexplained abnormal liver tests and atypical imaging without solitary or discrete lesions, as this rare malignancy can present furtively.

Hepatic Involvement of Diffuse Large B-Cell Lymphoma Mimicking Antinuclear Antibody-Negative Autoimmune Hepatitis Diagnosed by Liver Biopsy

“…In a retrospective study of liver biopsy performed on 259 patients with chronic liver disease, the liver biopsy changed the diagnosis and helped in performing clinical management in 70% of the patients [ 19 ]. There was even a case with unexplainable abnormal liver function with no abnormality in the image study but which was finally diagnosed as a primary liver lymphoma after performing a liver biopsy [ 20 ]. In terms of the safety of liver biopsy, major complications of liver biopsy, such as bleeding (causing hypotension and hematoma, requiring blood transfusion), can occur in 1–2% of the patients, and post-procedure mortality is reportedly <0.001–0.2% [ 21 ].…”

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

“… 8 The typical radiologic characteristics of the disease are space-occupying lesions in the liver or spleen. 3 Some patients exhibit diffuse lesions, displaying hepatosplenomegaly. 9 , 10 Conversely, the current patient only had jaundice without other accompanying symptoms such as fever and lymphadenopathy, and no space-occupying findings were identified by a series of radiologic examinations.…”

“… 17 Unfortunately, PHS-DLBCL is often diagnosed in an advanced stage in which therapeutic interventions offer little benefit. 3 The treatment of PHS-DLBCL includes surgery, radiotherapy, chemotherapy, and immunotherapy. Surgery combined with radiotherapy was previously considered to achieve favorable improvement.…”

“… 2 Although the pathogenesis of PHSL is uncertain, several etiological factors have been confirmed to increase the incidence of the disease, such as hepatitis virus infection (hepatitis A, B, and C) and autoimmune conditions. 3 Because this rare disease entity has neither a specific clinical manifestation nor significant tumor formation, liver biopsy is critical for clinical definite diagnosis.…”

Primary Hepatic Lymphoma Presenting as an Acute Abdomen in a Young Female Patient: A Case Report and Literature Review

“…The vast majority of PHL are NHL, most often a diffuse large B-cell lymphoma (DLBCL) type [1, 2]. PHL has a fairly nonspecific pattern of clinical presentation and laboratory and radiological findings [1–3]. The exact etiology of PHL is largely unknown, although associations have been linked to viral infections, immunosuppression, liver cirrhosis, primary biliary cirrhosis, and autoimmune diseases [3].…”