A Hepatic Lymphoma Mimicking Multiple Liver Metastases or an Intrahepatic Cholangiocarcinoma.
10.3904/kjm.2018.93.3.285
- Author:
Joo Hyun OH
1
;
Mun Seok CHOI
;
Dong Hyeon SHIN
;
Soek Jin KIM
;
Tae Uk KANG
;
Yeong Hye KOH
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drmschoi@gmail.com
- Publication Type:Case Report
- Keywords:
Liver neoplasm;
Lymphoma, Non-hodgkin;
Lymphoma, Large B-Cell, Diffuse;
Primary hepatic lymphoma
- MeSH:
Abdominal Pain;
Biomarkers, Tumor;
Biopsy;
Carcinoma, Hepatocellular;
Cholangiocarcinoma*;
Diagnosis;
Diagnosis, Differential;
Diagnostic Errors;
Female;
Humans;
Immunohistochemistry;
L-Lactate Dehydrogenase;
Liver Neoplasms;
Liver*;
Lung;
Lymphoma*;
Lymphoma, B-Cell;
Lymphoma, Large B-Cell, Diffuse;
Lymphoma, Non-Hodgkin;
Magnetic Resonance Imaging;
Middle Aged;
Neoplasm Metastasis*;
Risk Factors
- From:Korean Journal of Medicine
2018;93(3):285-290
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A primary hepatic lymphoma (PHL) is a rare malignancy; misdiagnosis and mistreatment are very common. We report the case of a 56-year-old female who presented with a 2-week history of upper abdominal pain. She exhibited no risk factors for hepatocellular carcinoma (HCC) and her serum tumor marker levels were normal. A computed tomography scan and gadolinium-enhanced magnetic resonance imaging of the liver revealed multiple liver masses, suggestive of multiple liver and lung metastases or an intrahepatic cholangiocarcinoma with lung metastasis. A diagnosis of PHL (a diffuse large B cell lymphoma) was confirmed by biopsy followed by immunohistochemistry. This case emphasizes that a PHL must be considered in the differential diagnosis of space-occupying liver lesions in patients with no risk factors for HCC and normal levels of serum tumor markers. It is notable that neither B cell lymphoma symptoms nor an elevated lactate dehydrogenase level were apparent in this case. We thus report a case of PHL mimicking multiple liver metastases or an intrahepatic cholangiocarcinoma, and we review the literature.
