Jaundice, hepatosplenomegaly, and portal lymphadenopathy in a middle‐aged female: Is it lymphoma?

Abstract

Primary biliary cholangitis is a rare liver disease which often progresses to cirrhosis. It can be difficult to diagnose as patients are often asymptomatic initially or merely complain of fatigue or pruritus. We describe the case of a 56‐year‐old female who presented with a 2‐month history of painless jaundice and constitutional symptoms. Computed tomography scan showed massive hepatosplenomegaly with abdominal lymphadenopathy. Liver biopsy and a strongly positive antimitochondrial antibody titer confirmed the diagnosis of primary biliary cholangitis.

A Middle-Aged Woman with Elevated Serum CA19-9 and Lymphadenopathy

“…2 In this case, elevated serum CA 19-9 is considered to be caused by cholangitis, as a consequence of primary biliary cholangitis. 3 These findings may lead clinicians to suspect malignancy and to make diagnostic errors. As such, to prevent diagnostic pitfalls, primary biliary cholangitis should be considered as a differential diagnosis for female patients with elevated serum CA 19-9 and lymphadenopathy of unknown origin.…”