(February 27, 2018) An Unusual Presentation of Primary Hepatic Diffuse Large B-cell Lymphoma of the Liver. [cureus.com]

Satellite nodules were seen at presentation in one case and developed after presentation in two others. Other features, such as enhancement after contrast administration, necrosis, and calcification, were variable. [ajronline.org]

Sub-acute liver failure is an uncommon presentation of primary hepatic lymphoma. Herein, we present a patient who presented with sub-acute liver failure and jaundice due to primary hepatic follicular lymphoma. [journals.sagepub.com]

Portal hypertension was, however, not present. Exploratory laparotomy revealed nodular regenerative hyperplasia of the liver. The nontumorous liver was normal. [keio.pure.elsevier.com]

CASE PRESENTATION A 65-year-old man presented to his primary care physician in August 2008 with a 2-month history of constipation and occasional right groin pain. His history was significant for right inguinal hernia repaired in 1970. [ncbi.nlm.nih.gov]

• Mediastinal Lymphadenopathy

  CT of the chest did not reveal any mediastinal lymphadenopathy. Past history did not appear to be contributory regarding the aetiology. Liver biopsy examination confirmed a diagnosis of non-Hodgkin’s anaplastic large-cell lymphoma of T phenotype. [oapublishinglondon.com]

  Radiography and ct scan of chest did not reveal any mediastinal lymphadenopathy. Magnetic resonance imaging further confirmed the ct findings ( Figure 3 ). [ncbi.nlm.nih.gov]

• Abdominal Lymphadenopathy

  No ultrasonographic evidence of intra abdominal lymphadenopathy was seen. [omicsonline.org]

• Weight Gain

  Clinically, the diagnosis is suspected when jaundice, painful hepatomegaly, and unexplained weight gain, with or without ascites, occur soon after HSCT. Diagnostic criteria have been formulated (Table 4 ). [aasldpubs.onlinelibrary.wiley.com]

• Leg Swelling

  Case Presentation A 71-year-old Japanese man was admitted with new onset jaundice, leg swelling, abdominal distention, pruritus, multiple ecchymotic lesions, and mild behavioral changes. [journals.sagepub.com]

• Rigor

  He denied any fever, chills, and rigors. He had fatigue, and felt early satiety due to pressure in the left upper quadrant of abdomen. He denied any travel to the countryside, significant outdoor activities, hiking or spelunking. [dovepress.com]

• Constipation

  CASE PRESENTATION A 65-year-old man presented to his primary care physician in August 2008 with a 2-month history of constipation and occasional right groin pain. His history was significant for right inguinal hernia repaired in 1970. [ncbi.nlm.nih.gov]

• Regurgitation

  The patient’s history was also significant for hypothyroidism, hypertension, gout, type 2 diabetes mellitus, hyperlipidemia, and mitral valve disease without regurgitation. [ncbi.nlm.nih.gov]

• Dermatitis

  The term acute graft versus host disease (aGVHD) describes a distinct syndrome of dermatitis, hepatitis, and enteritis, usually occurring within the first 100 days after HSCT. [aasldpubs.onlinelibrary.wiley.com]

• Epistaxis

  He reportedly had history of easy bruising, epistaxis, and bright red blood per rectum, which worsened around 3 days prior. [journals.sagepub.com]

• Enlargement of the Prostate

  MDCT scans showed a focal liver lesion in the right lobe, and a mild enlargement of the prostate gland. No other abnormalities were identified in the rest of his chest and abdomen. [jmedicalcasereports.biomedcentral.com]

• Neglect

  Hepatitis B reactivation following immunosuppressive therapy and screening adherence: a neglected problem?, Dtsch. Med. Wochenschr. 137 (2012) 1458-1462. [71] M.P. [scipress.com]

Table 2 Laboratory data A workup for causes of increased LFTs had been initiated on HD 1. [dovepress.com]

Figure 1 Imaging workup. [casereports.bmj.com]

This case highlights the importance of pursuing a liver biopsy early in the workup for abnormal liver tests of an unclear etiology, even in the absence of a liver lesion on imaging, as in some instances a more expedited diagnosis can improve prognosis [cureus.com]

[…] lymphomas. [4] 68 cases of primary MALTomas have been reported in literature till date. [3] Mean age of presentation is the sixth decade with slight female predilection. [2] Hepatic MALTomas are mostly incidentally detected during surgery or on imaging workup [ijpmonline.org]

A thorough workup is helpful including HBsAg, HCV antibodies, EBV IgM or PCR, and HIV serology. [ncbi.nlm.nih.gov]

• Right Pleural Effusion

  The patient had mild ascites and right pleural effusion that required pleural punctation because of restrictive pulmonary insufficiency. He was discharged from the hospital on the 14 th postoperative day. [scielo.br]

• Poikilocytosis

  Initial review of a peripheral blood smear showed thrombocytopenia with occasional large platelets, poikilocytosis, polychromasia, decreased white blood cells without toxic granulation and no schistocytes. [dovepress.com]

Recurring tumors have worse prognosis compared to tumors that do not recur Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond to treatment Progression of the condition makes the outcome [dovemed.com]

Since chemotherapy is the treatment of first choice for lymphoma, adjuvant chemotherapy should be given to patients for optimal treatment[ 1 ]. The existing literature on PHL reveals the difficulties involved in diagnosis and treatment. [ncbi.nlm.nih.gov]

Surgery is also described as a possible treatment, but with less promising results and higher rates of recurrence. [elsevier.es]

Depending on the stage of the condition, treatment may involve chemotherapy, biopsy, radiation and medication. Alternative medicine Complementary medicine may be helpful along with conventional treatment. [liverdoctor.com]

Abstract We present a case of successful treatment of chemoresistant hepatic lymphoma using yttrium-90 micropheres. [ashpublications.org]

The prognosis for patients with PHL relates to the specific disease entity. [oapublishinglondon.com]

Freeman C, Berg JW, Cutler SJ (1972) Occurrence and prognosis of extranodal lymphomas. Cancer 29: 252-260. [omicsonline.org]

PHL is associated with a poor prognosis due to its aggressive nature and frequent severe co-morbidity. Of 72 PHL patients described in literature the median survival is only 15.3 mo. [ncbi.nlm.nih.gov]

The overall prognosis is poor, and the median overall survival for these patients has been estimated to be approximately 33 months [6]. [cureus.com]

The etiology of primary hepatic DLBCL is unknown. [cureus.com]

Etiology of MALToma is unclear. Chronic inflammation is known to be the possible trigger including chronic gastritis associated with H. pylori infection. [ijpmonline.org]

In the setting of worsening symptoms and abnormal liver enzymes of unknown etiology, clinicians should consider performing a differential liver biopsy. [wjgnet.com]

A workup for infectious etiologies was performed as summarized in Table 1. Testing for human immunodeficiency virus was negative. A bone marrow biopsy was performed on HD 4. [dovepress.com]

(Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes. [dovemed.com]

Therefore, since the Birmingham (UK) group emphasized that the establishment of a histopathology data pool improves epidemiological analysis, this paper is based on such a pool used by the Igbo ethnic group [5, 6]. [symbiosisonlinepublishing.com]

To evaluate which patients with NHL are at the highest risk of developing an infection-related second cancer, the researchers reviewed 17 Surveillance, Epidemiology, and End Results (SEER) Program registries to identify 127,044 adults who received their [ashclinicalnews.org]

To date, fewer than 400 PHL cases have been reported in the worldwide literature 3, 7, 8, 18, 21, 25, 29 – 31 and large case series. 6, 9, 10, 14, 32 Methods Data source The Surveillance Epidemiology and End Results (SEER) program of the U.S National [xiahepublishing.com]

Surveillance Epidemiology and End Results (SEER). Bethesda, MD: National Cancer Institute. Archived from the original on 26 September 2009. Retrieved 3 November 2009. Table 1.4: Age-Adjusted SEER Incidence and U.S. [en.wikipedia.org]

Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in parts of England and Wales. Hematol J. 2002;3(2):95–104. 8- Maher MM, McDermott SR, Fenlon HM, Conroy D, O’Keane JC, Carney DN, et al. [tunisiechirurgicale.com]

Bilirubin 2 mg/dL ( 34 μmol/L) before day 21 post‐HSCT and at least two of the following: • Hepatomegaly • Ascites • Weight gain 5% from baseline Summary Assessing liver dysfunction in the context of lymphoma or after HSCT requires an understanding of the pathophysiology [aasldpubs.onlinelibrary.wiley.com]

Pathophysiology Despite a well established underlying pathophysiology in the pathogenesis of other forms of lymphoma; both non-Hodgkin and Hodgkin lymphoma, the pathophysiology underlying primary hepatic lymphoma is largely underdetermined. [ncbi.nlm.nih.gov]

“It seems intuitive to eradicate HCV to prevent HCV-NHL as very few patients who attained an SVR developed such cancer,” the researchers wrote. “Our findings suggest the need for early AVT in infected patients. [healio.com]

How can Lymphoma of Liver be Prevented? Currently, it is not possible to prevent Lymphoma of Liver. However, controlling certain factors may help lower one’s risk for the condition. [dovemed.com]

A high index of suspicion and liver biopsy early in the course of liver dysfunction may establish the diagnosis and allow rapid initiation of chemotherapy to prevent a fatal outcome. [ejcrim.com]

[…] chemotherapy or radiation therapy include: Bone marrow diseases (such as leukemia) Heart disease Inability to have children ( infertility ) Lung problems Other cancers Thyroid problems Keep following up with a provider who knows about monitoring and preventing [medlineplus.gov]

Burkitt lymphoma may spread to the brain and spinal cord and treatment to prevent its spread may be given. [cancer.gov]