Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type

Abstract

Rationale:Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. To the best of our knowledge, only 67 cases had been reported in 39 English literatures to date. The aim of this study was to add a new case of this disease to the literature and to review the current literature.Patient concerns:A 50-year-old man was incidentally identified with a solitary mass of 5 cm in diameter in the left lobe of the liver.Diagnoses:Based on the results of imaging studies, intrahepatic cholangiocellular carcinoma was suspected, and then surgery was performed. Microscopic findings showed that the tumor was a hepatic MALT lymphoma, and immunohistochemical analysis revealed that the lymphoma cells were CD20+, CD79a+, BCL-2+, CD3−, and CD5−.Interventions:The patient received rituximab after surgery.Outcomes:He was free of disease for 13 months at the time of this report.Lessons:Since previously published case reports and our case described nonspecific clinical features of this rare disease, it was usually misdiagnosed before histological confirmation and surgery resection may be a good choice for both diagnosis and local therapy.

Primary hepatic extranodal marginal zone B-cell lymphoma treated by surgical resection: A case report

“…3,8 Literature MRI findings of primary hepatic MALT lymphoma are similar to those in our case, including hypointensity on T1-weighted images, moderate hyperintensity on T2-weighted images, and a slight and peripheral enhancement pattern. 9 Therefore, in most cases, the preoperative diagnosis was non-specific, prompting biopsy (8,9) or surgery if there was suspicion of cholangiocellular carcinoma 3,7 or hepatocellular carcinoma. 8 The etiology of hepatic primary lymphoma is not fully understood.…”

“…6,7 These tumors commonly present with a solitary mass (74% of cases) 0.7-9.0 cm in size. 3,7 On contrast-enhanced CT scan, primary hepatic MALT lymphoma has a variable pattern, including no enhancement, faint enhancement, or peripheral enhancement in the early arterial phase. 3,8 Literature MRI findings of primary hepatic MALT lymphoma are similar to those in our case, including hypointensity on T1-weighted images, moderate hyperintensity on T2-weighted images, and a slight and peripheral enhancement pattern.…”

“…3,7 On contrast-enhanced CT scan, primary hepatic MALT lymphoma has a variable pattern, including no enhancement, faint enhancement, or peripheral enhancement in the early arterial phase. 3,8 Literature MRI findings of primary hepatic MALT lymphoma are similar to those in our case, including hypointensity on T1-weighted images, moderate hyperintensity on T2-weighted images, and a slight and peripheral enhancement pattern. 9 Therefore, in most cases, the preoperative diagnosis was non-specific, prompting biopsy (8,9) or surgery if there was suspicion of cholangiocellular carcinoma 3,7 or hepatocellular carcinoma.…”

“…Extranodal marginal zone B-cell lymphoma (also known as mucosa-associated lymphoid tissue (MALT) lymphoma) is the most common type of marginal zone lymphoma, accounting for 7-8% of all NHLs. 3 These rare extranodal marginal zones B-cell lymphomas most commonly originate in the stomach. However, these tumors can also arise in any extranodal site, including the skin, conjunctiva, salivary gland, thyroid, lung, breast, gallbladder, and liver.…”

“…Based on a literature review by Dong at al. 3 in 2017, only 67 cases of primary hepatic lymphoma have been reported worldwide. We report a case of primary hepatic extranodal marginal zone B-cell lymphoma (or MALT lymphoma) diagnosed after surgical resection, with suspected concurrent hepatocellular carcinoma.…”