Primary Hepatic Burkitt’s Lymphoma with Chronic Hepatitis C

Abstract

The liver is an uncommon primary site for malignant lymphoma, and primary hepatic lymphoma has been found to make up 0.4% of all extranodal lymphomas. We report a rare case of a 75-year-old Japanese male with primary hepatic Burkitt’s lymphoma, according to both the revised European-American Lymphoma classification and the new World Health Organization classification. As not only histological findings but also immunological features are deemed essential in the diagnosis of Burkitt’s lymphoma, the previous 7 cases of primary hepatic Burkitt’s lymphoma were not fully evaluated, using these criteria. As far as we know, this is the first case of primary hepatic Burkitt’s lymphoma with typical features on histological, immunological and cytogenetical analysis. He had a history of chronic hepatitis C over several decades with subsequent liver cirrhosis. From our review of the literature and our case, the relationship between hepatitis C virus infection and the development of primary hepatic Burkitt’s lymphoma remains obscure.

Non-Hodgkin Lymphoma of the Liver: A US Population-based Analysis

“…In addition, 40% of deaths in hepatic Burkitt’s lymphoma were related to HIV-related complications. Of note, primary hepatic Burkitt’s lymphoma had been reported in concurrent viral infection, such as HIV,44,45 HCV46 and HBV 47. Anti-HIV therapy has no significant impact on outcomes of HIV-Burkitt’s lymphoma48 compared to some HIV-related lymphomas, such as primary effusion lymphoma 49.…”

Primary Hepatic Burkitt Lymphoma Presenting with Acute Liver Failure

“…There have been seven cases of PH-BL reported in adults [2][3][4][5][6][7][8], but only five cases had confirmed immunophenotypic diagnosis [2][3][4][5][6]. Symptoms reported on presentation were abdominal pain and distension, nausea, vomiting, fever, weight loss, jaundice, and diarrhea.…”

“…Burkitt lymphoma (BL) is a highly aggressive B-cell subset of NHL [1]. To our knowledge, only five cases have been reported with a confirmed immunophenotypic diagnosis of primary hepatic BL (PH-BL), but none had acute liver failure (ALF) [2][3][4][5][6].…”

A Role for RNA Viruses in the Pathogenesis of Burkitt's Lymphoma: The Need for Reappraisal

“…It is of particular interest and relevance to this paper that rare instances of sporadic Burkitt's lymphoma arising in connection with chronic HCV infection have been recorded [164–166]. They included a number of primary hepatic BLs [164], a cardiac lymphoma with variant BL translocation and a gingival BL arising in a renal transplant patient with chronic HCV infection [165, 166].…”

“…They included a number of primary hepatic BLs [164], a cardiac lymphoma with variant BL translocation and a gingival BL arising in a renal transplant patient with chronic HCV infection [165, 166]. Under-ascertainment of HCV-associated BL is likely, unless there is a high index of diagnostic suspicion.…”