Patterns of liver infiltration in lymphoproliferative disease

Abstract

Distinct lymphoma subtypes show characteristic patterns of liver infiltration. Additional molecular analyses can support diagnosis by verification of clonality or detection of characteristic genetic aberrations.

Hepatic pseudolymphoma: a clinicopathological study of five cases and review of the literature

“…28,29 Interestingly, marginal-zone B-cell lymphoma, the most important differential diagnosis of hepatic pseudolymphoma, showed this pattern in only one case (6% of 16 cases). 28,29 It is still ambiguous whether or not a characteristic pattern of infiltration at the edge of hepatic pseudolymphoma can be observed in low-grade B-cell lymphoma. But, unique features observed in needle biopsies (Figure 4) was not described in those two studies.…”

“…Two previous studies examined patterns of hepatic infiltration in malignant lymphoma. 28,29 The studies examined 294 cases in total, including 76 cases of low-grade B-cell lymphomas (marginal-zone B-cell lymphoma, B-CLL, mantle cell lymphoma, and follicular lymphoma). 28,29 The patterns of hepatic infiltration were classified into nodular, portal, and sinusoidal.…”

“…28,29 The studies examined 294 cases in total, including 76 cases of low-grade B-cell lymphomas (marginal-zone B-cell lymphoma, B-CLL, mantle cell lymphoma, and follicular lymphoma). 28,29 The patterns of hepatic infiltration were classified into nodular, portal, and sinusoidal. Interestingly, combined results of both studies, most of low-grade B-cell lymphomas showed a predominantly portal infiltration pattern with or without sinusoidal infiltration.…”

Idelalisib given front-line for treatment of chronic lymphocytic leukemia causes frequent immune-mediated hepatotoxicity

“…No significant mononuclear infiltrate was seen in healthy liver, whereas clusters of CD20 1 periportal lymphocytes and scattered intraparenchymal CD8 1 , perforin-negative cytotoxic T cells were seen in the patient with CLL, consistent with previous reports. 18 However, biopsy specimens from the CLL patients experiencing idelalisib-related transaminitis showed an increased infiltrate of CD8 1 cytotoxic T cells that also stained positive for perforin, indicating an activated state ( Figure 3A). Similar biopsy findings were noted in sections of duodenum taken from a subject on trial experiencing idelalisib-related enteritis, with CD8 1 cytotoxic lymphocytes infiltrating the lamina propria ( Figure 3B).…”

Recent developments in liver pathology

“…Brief mention should be made of a helpful study by Baumhoer et al [93], which examined the pattern of lymphoma infiltration of liver biopsies. Notable findings included the tendency of chronic lymphocytic leukemia and Hodgkin lymphoma to infiltrate portal tracts and the presence of lymphoepithelial lesions involving bile ducts in 10% of cases of marginal B cell lymphoma and Hodgkin lymphoma.…”