1
|
Pedicelli A, Michel RP, Sebastiani G. An Unusual Cause of Acute Liver Failure Diagnosed on Organ Explant in a Patient With Ulcerative Colitis. Gastroenterology 2024:S0016-5085(24)05174-6. [PMID: 38950829 DOI: 10.1053/j.gastro.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Accepted: 06/22/2024] [Indexed: 07/03/2024]
Affiliation(s)
- Alessandro Pedicelli
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University, Montreal, QC, Canada.
| | - René P Michel
- Department of Pathology, McGill University, Montreal, QC, Canada
| | - Giada Sebastiani
- Division of Gastroenterology and Hepatology, Department of Medicine, McGill University, Montreal, QC, Canada
| |
Collapse
|
2
|
Koh HD, Choi JW, Kim EK, Park S, Kim MJ, Lee CK. Primary hepatic mucosa-associated lymphoid tissue lymphoma mimicking hepatocellular carcinoma in a patient with chronic hepatitis B: a case report. J Int Med Res 2023; 51:3000605231154399. [PMID: 36788763 PMCID: PMC9932769 DOI: 10.1177/03000605231154399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Primary hepatic lymphoma is a rare disease, and primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma accounts for only 0.3% of all primary hepatic lymphomas. Herein, we report a case of primary hepatic MALT lymphoma in a male patient in his mid-40 s with chronic hepatitis B infection. The patient visited our department for further examination of a hepatic nodule initially visualized through abdominal pelvic computed tomography (CT). Based on imaging studies and elevated levels of tumor markers, the tumor was suspected to be hepatocellular carcinoma. A laparoscopic inferior sectionectomy (segment 5 and 6) was performed, and immunohistochemical staining revealed that the tumor was positive for CD20, B-cell lymphoma 2, pan-cytokeratin (CK), and CK19 markers. Pathological findings revealed it to be a primary hepatic MALT lymphoma. After surgery, bone marrow biopsies and fluorodeoxyglucose-positron emission tomography integrated with CT scanning confirmed that there was no other involvement. The patient did not receive chemotherapy, and there was no recurrence during the 24-month follow-up period. Hepatocellular carcinoma is the most common malignancy in patients with chronic hepatitis B, but rare tumors such as primary MALT lymphoma can also occur, so a careful approach is required for their differentiation.
Collapse
Affiliation(s)
- Hee Dong Koh
- Department of Internal Medicine, National Health Insurance
Service Ilsan Hospital, Goyang-shi, Republic of Korea
| | - Jong Won Choi
- Department of Internal Medicine, National Health Insurance
Service Ilsan Hospital, Goyang-shi, Republic of Korea,Jong Won Choi, Department of Internal
Medicine, National Health Insurance Service Ilsan Hospital, Baeksuk-1-dong 1232,
Ilsandong-ku, Goyang-shi 10444, Republic of Korea.
| | - Eun Kyung Kim
- Department of Pathology, National Health Insurance Service Ilsan
Hospital, Goyang-shi, Republic of Korea
| | - Sumi Park
- Department of Radiology, National Health Insurance Service Ilsan
Hospital, Goyang-shi, Republic of Korea
| | - Min Ji Kim
- Department of Internal Medicine, National Health Insurance
Service Ilsan Hospital, Goyang-shi, Republic of Korea
| | - Chun Kyon Lee
- Department of Internal Medicine, National Health Insurance
Service Ilsan Hospital, Goyang-shi, Republic of Korea
| |
Collapse
|
3
|
Lau WY, Ho K, Chan FK, Lam S, Cheng K. Primary hepatic mucosa‐associated lymphoid tissue lymphoma: Case report and literature review. SURGICAL PRACTICE 2022. [DOI: 10.1111/1744-1633.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Wing Yu Lau
- Department of Surgery Kwong Wah Hospital Yau Ma Tei Hong Kong
| | - Kit‐Man Ho
- Department of Surgery Kwong Wah Hospital Yau Ma Tei Hong Kong
| | | | - Shi Lam
- Department of Surgery Kwong Wah Hospital Yau Ma Tei Hong Kong
| | - Kai‐Chi Cheng
- Department of Surgery Kwong Wah Hospital Yau Ma Tei Hong Kong
| |
Collapse
|
4
|
Yasuda T, Nakagawa S, Imai K, Okabe H, Hayashi H, Yamashita YI, Chikamoto A, Ozono K, Mikami Y, Baba H. A case of primary hepatic mucosa-associated lymphoid tissue lymphoma incidentally found in the sustained virological response state of chronic hepatitis C: review of the literature of this rare disease. Int Cancer Conf J 2020; 9:59-65. [PMID: 32257755 DOI: 10.1007/s13691-019-00397-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023] Open
Abstract
A 54-year-old woman finished the treatment for chronic hepatitis C and achieved sustained virological response. She was identified with some tumor lesions at her liver during follow-up observation by ultrasonography. From contrast-enhanced computed tomography, there were four tumors at sub-segment 4/5, S5, S6, and S7. These lesions are slightly enhanced on arterial phase and washed out on delayed phase. Contrast-enhanced magnetic resonance imaging showed slight enhancement on arterial phase and defect on hepatocyte phase. Tumor markers including alpha fetoprotein, Des-Gamma-Carboxy Prothrombin, carcinoembryonic antigen, and carbohydrate antigen (CA19-9) were within normal range. The patient underwent partial hepatectomies of four tumors at S4/5, S5, S6, and S7. The patient was recovering well, so he discharged our hospital after 10 days from the operation. The histological assay of the resected specimen showed accumulation of lymphocyte with hyperplasia of lymphoid follicles accordant with tumor lesions. Immunohistochemical staining assay revealed a positive for CD3, CD20, CD10, and bcl-2. These findings eventually made a diagnosis of all four tumors as mucosa-associated lymphoid tissue lymphoma. Since previously published case reports and our case described nonspecific clinical features of this rare disease, it was difficult to get the certain diagnosis before histological confirmation and non-anatomical partial liver resection may be a good choice for both diagnosis and local therapy.
Collapse
Affiliation(s)
- Tadahito Yasuda
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Shigeki Nakagawa
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Katsunori Imai
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hirohisa Okabe
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hiromitsu Hayashi
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Yo-Ichi Yamashita
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Akira Chikamoto
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Kazutaka Ozono
- 2Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Yoshiki Mikami
- 2Department of Diagnostic Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| | - Hideo Baba
- 1Department of Gastroenterology, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan
| |
Collapse
|
5
|
Xie H, Lv J, Ji Y, Du X, Yang X. Primary hepatic mucosa-associated lymphoid tissue lymphoma: A case report and literature review. Medicine (Baltimore) 2019; 98:e15034. [PMID: 30921228 PMCID: PMC6456129 DOI: 10.1097/md.0000000000015034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and there is no consensus yet on the treatment modalities. Here, we report a new case of MALT lymphoma and review the current literature on this disease. PATIENT CONCERNS A 73-year-old man was admitted to our department following the incidental finding of a solitary 1.8-cm diameter mass in the liver. DIAGNOSIS Microscopic findings identified the mass as a tumor with infiltration of diffuse atypical B lymphocytes. Immunohistochemical analysis showed positivity for CD20 and CD79a, and negativity for CD3 and CD5. These collective data led to the diagnosis of primary hepatic MALT lymphoma. INTERVENTIONS The tumor was removed by surgical resection. The patient refused additional treatment after the surgery. OUTCOMES At the time of writing this report, the patient has been disease free for 6 months postsurgery. LESSONS Review of the previously published case reports on this rare tumor type indicates that in addition to chronic liver inflammation due to infection or other reasons, genetic aberrations can also contribute to the development of hepatic MALT lymphoma. Additionally, IgH rearrangement is a good genetic hallmark of this tumor. Owing to no specific clinical or radiologic features to define the disease profile for diagnosis, surgery may be a good choice for both diagnosis and therapy if the patient's condition permits.
Collapse
|
6
|
Primary Hepatic Lymphoma Mimicking a Hepatocellular Carcinoma in a Cirrhotic Patient: Case Report and Systematic Review of the Literature. Case Rep Surg 2018; 2018:9183717. [PMID: 29850362 PMCID: PMC5914115 DOI: 10.1155/2018/9183717] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/31/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Primary hepatic lymphomas (PHLs) are rare liver tumors, frequently misdiagnosed preoperatively. As these tumors could be successfully treated with chemotherapy, their early recognition is essential, potentially, to avoid useless surgery. We report on the case of a cirrhotic patient with hemochromatosis who presented a PHL, initially diagnosed as a hepatocellular carcinoma (HCC), and we analyze recent data from the literature on this subject. Case Presentation and Review of the Literature A 45 mm liver tumor was found is a 68-year-old man with alcohol cirrhosis and hemochromatosis. At imaging, the diagnosis of HCC was suspected according to vascular characteristics and the presence of cirrhosis. FDG PET scan showed a solitary hypermetabolic liver tumor. Tumor markers were negative. Surgery consisted in left lateral hepatectomy. At pathology, the diagnosis of the primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) type was demonstrated. Twenty-two articles reporting 33 cases of true PHL of MALT type were found. Presentation lacked specific symptoms (70% asymptomatic). Half of patients were suspected to have other etiologies of liver mass (HCC, intrahepatic cholangiocarcinoma), and thus diagnosis was established postoperatively. In the patient, diagnosis was made by preoperative biopsy, and chemotherapy was first-line treatment. Discussion Preoperative diagnosis of PHL, and particularly of primary hepatic MALT lymphoma, is challenging. This case illustrates that PHL remains to be considered among the differential diagnosis of isolated solid liver tumors. Further, it indicates that biopsy could be still indicated in case of suspected HCC in cirrhotic patients, particularly in the presence of unusual findings such as the combination of a FDG PET scan positive tumor in the absence of elevated alpha-fetoprotein.
Collapse
|
7
|
Bierman PJ. Solid Organ Transplantation in Patients With a History of Lymphoma. J Oncol Pract 2018; 14:11-17. [DOI: 10.1200/jop.2017.028480] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
There is an increasing number of long-term survivors of Hodgkin and non-Hodgkin lymphoma. These people may have a need for subsequent solid organ transplantation, often as a result of late effects of their lymphoma treatment. There is abundant literature demonstrating that patients with a history of lymphoma are appropriate candidates for solid organ transplantation. Long-term survival without relapse and with a functioning graft is possible. Patients with a history of post-transplantation lymphoproliferative disorders and patients who have received a prior hematopoietic stem-cell transplantation may also be candidates. Although high-level supporting evidence is not available, most guidelines recommend a waiting period of 2 to 5 years after lymphoma treatment before patients undergo solid organ transplantation. Each patient with a history of lymphoma requires a multidisciplinary approach and should be evaluated on a case-by-case basis before consideration of solid organ transplantation.
Collapse
|
8
|
Dong S, Chen L, Chen Y, Chen X. Primary hepatic extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type: A case report and literature review. Medicine (Baltimore) 2017; 96:e6305. [PMID: 28353562 PMCID: PMC5380246 DOI: 10.1097/md.0000000000006305] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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.
Collapse
|
9
|
Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review. Surg Case Rep 2015; 1:87. [PMID: 26435907 PMCID: PMC4580714 DOI: 10.1186/s40792-015-0091-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/17/2015] [Indexed: 12/20/2022] Open
Abstract
Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. We herein describe the findings in a 74-year-old man with elevated liver enzyme levels. Dynamic computed tomography showed focal biliary dilation and atrophy in the posterior segment, while dynamic magnetic resonance images revealed a small, highly enhanced small mass located at the root of posterior branch of the biliary ducts. As the mass was not detected on abdominal ultrasonography, a biopsy could not be performed. Cholangiocellular carcinoma was suspected, and surgery was performed. However, the surgically resected hepatic tumor was a nodule of aggregated lymphocytes that formed a lymphoepithelial lesion. Immunohistochemical analysis revealed that the lymphoma cells were positive for CD20 and CD79a, but negative for CD3. No other lymphoid lesions were found during additional postoperative examinations. Therefore, the patient was diagnosed with primary hepatic MALT lymphoma. He was also diagnosed with Helicobacter pylori infection, and thus, pylorus eradication was performed. At the time of this report, the patient was free of disease for 2 years without any additional treatment. The present case contributed to the diagnosis and management of this rare disease, as previously published case reports described varying imaging features; it also suggested that preoperative diagnosis was often difficult without biopsy.
Collapse
|
10
|
Zhong Y, Wang X, Deng M, Fang H, Xu R. Primary hepatic mucosa-associated lymphoid tissue lymphoma and hemangioma with chronic hepatitis B virus infection as an underlying condition. Biosci Trends 2015; 8:185-8. [PMID: 25030854 DOI: 10.5582/bst.2014.01057] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma has a low incidence and is a rare subtype of hepatic malignant lymphoma. Described here is a rare case of primary hepatic MALT lymphoma and hepatic hemangioma with chronic HBV infection as an underlying condition. Possible treatment modalities, which should be selected in accordance with tumor size, tumor location, tumor number, and underlying liver disease, are discussed in conjunction with a review of the literature. In addition, the potential use of hepatic resection, radio frequency ablation (RFA), or radiotherapy followed by chemotherapy via the R-CHOP regimen is also discussed.
Collapse
Affiliation(s)
- Yuesi Zhong
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University
| | | | | | | | | |
Collapse
|
11
|
Kikuma K, Watanabe J, Oshiro Y, Shimogama T, Honda Y, Okamura S, Higaki K, Uike N, Soda T, Momosaki S, Yokota T, Toyoshima S, Takeshita M. Etiological factors in primary hepatic B-cell lymphoma. Virchows Arch 2012; 460:379-87. [PMID: 22395482 PMCID: PMC3320708 DOI: 10.1007/s00428-012-1199-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 01/08/2012] [Accepted: 01/19/2012] [Indexed: 12/26/2022]
Abstract
Sixty-four cases of malignant lymphoma involving the liver were examined. Of these, 20 cases were histologically confirmed to be primary hepatic B-cell lymphoma. Twelve of these 20 cases were diffuse large B-cell lymphoma (DLBCL) and eight cases were mucosa-associated lymphoid tissue (MALT) lymphoma. Of the 12 cases of DLBCL, six were immunohistologically positive for CD10 and/or Bcl6 (indicating a germinal center phenotype), six were positive for Bcl2, and five were positive for CD25. Eight of the 12 DLBCL cases (66.7%) and two of the eight MALT lymphoma cases (25%) had serum anti-hepatitis C virus (HCV) antibodies and HCV RNA. The incidence of HCV infection was significantly higher in the hepatic DLBCL cases than in systemic intravascular large B-cell cases with liver involvement (one of 11 cases, 9.1%) and T/NK-cell lymphoma cases (one of 19 cases, 5.3%) (p < 0.01 for both). Two hepatic DLBCL cases (16.7%) had rheumatoid arthritis treated with methotrexate, and four MALT lymphoma cases (50%) had Sjögren’s syndrome, primary biliary cirrhosis, or autoimmune hepatitis; one case in each of these two groups was complicated by chronic HCV-seropositive hepatitis. Although primary hepatic lymphoma is rare, persistent inflammatory processes associated with HCV infection or autoimmune disease may play independent roles in the lymphomagenesis of hepatic B cells.
Collapse
Affiliation(s)
- Kanta Kikuma
- Departments of Pathology and Internal Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7-45-1, Johnan-ku, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Multinodular pseudolymphoma of the liver: computed tomography and magnetic resonance imaging findings. Jpn J Radiol 2011; 29:524-7. [PMID: 21882097 DOI: 10.1007/s11604-011-0581-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 02/23/2011] [Indexed: 02/07/2023]
Abstract
A 60-year-old woman who had had a history of renal cell carcinoma with intraperitoneal recurrence presented with multiple liver masses. Computed tomography demonstrated multiple enhancing lesions in the both lobes of the liver, and there was an apparent small vessel coursing within one of the lesions. On magnetic resonance imaging, masses showed slight T1 and T2 prolongation, and restricted diffusion: On the hepatobiliary phase of liver-specific contrast agent enhancement, lesions were shown as low signal intensity of varying degree. Liver metastases from renal cell carcinoma were suspected, and partial hepatectomy was performed for the superficially located nodules to make a definitive diagnosis. The final pathological diagnosis was reactive lymphoid hyperplasia or pseudolymphoma of the liver.
Collapse
|
13
|
Hayashi M, Yonetani N, Hirokawa F, Asakuma M, Miyaji K, Takeshita A, Yamamoto K, Haga H, Takubo T, Tanigawa N. An operative case of hepatic pseudolymphoma difficult to differentiate from primary hepatic marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue. World J Surg Oncol 2011; 9:3. [PMID: 21232116 PMCID: PMC3033353 DOI: 10.1186/1477-7819-9-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 01/13/2011] [Indexed: 12/16/2022] Open
Abstract
Hepatic pseudolymphoma (HPL) and primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) are rare diseases and the differential diagnosis between these two entities is sometimes difficult. We herein report a 56-year-old Japanese woman who was pointed out to have a space occupying lesion in the left lateral segment of the liver. Hepatitis viral-associated antigen/antibody was negative and liver function tests including lactic dehydrogenase, peripheral blood count, tumor markers and soluble interleukin-2 receptor were all within normal limit. Imaging study using computed tomography and magnetic resonance imaging were not typical for hepatocellular carcinoma, cholangiocarcinoma, or other metastatic cancer. Fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning showed high standardized uptake value in the solitary lesion in the liver. Under a diagnosis of primary liver neoplasm, laparoscopic-assisted lateral segmentectomy was performed. Liver tumor of maximal 1.0 cm in diameter was consisted of aggregation of lymphocytes of predominantly B-cell, containing multiple lymphocyte follicles positive for CD10 and bcl-2, consistent with a diagnosis of HPL rather than MALT lymphoma, although a definitive differentiation was pending. The background liver showed non-alcoholic fatty liver disease/early non-alcoholic steatohepatitis. The patient is currently doing well with no sign of relapse 13 months after the surgery. Since the accurate diagnosis is difficult, laparoscopic approach would provide a reasonable procedure of diagnostic and therapeutic advantage with minimal invasiveness for patients. Considering that the real nature of this entity remains unclear, vigilant follow-up of patient is essential.
Collapse
Affiliation(s)
- Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Doi H, Horiike N, Hiraoka A, Koizumi Y, Yamamoto Y, Hasebe A, Ichikawa S, Yano M, Miyamoto Y, Ninomiya T, Ishimaru Y, Miyagawa M, Takamura K, Kawasaki H, Kozuka T, Maeda T, Yoshino T. Primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type: case report and review of the literature. Int J Hematol 2008; 88:418-423. [PMID: 18807227 DOI: 10.1007/s12185-008-0153-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2008] [Revised: 06/22/2008] [Accepted: 07/04/2008] [Indexed: 12/12/2022]
Abstract
A primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) is very rare. We found a solitary mass 27 mm in size in the left lobe of the liver of a 58-year-old Japanese man with a history of hepatitis-C infection. Based on the results of imaging studies, the tumor was diagnosed as a hepatocellular carcinoma (HCC). The left lobe of the liver was lobectomized and microscopic findings showed that the tumor was a hepatic MALT lymphoma, while immunohistochemistry showed it to be positive for CD20 and CD79a. In a fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning (FDG-PET CT) before surgery, the tumor was revealed to have a high standardized uptake value (SUV) for FDG. The patient received chemotherapy after surgery. To the best of our knowledge, 45 cases had been reported with a mean age for all patients of 61.4 years. The pathogenesis remains unclear, although half of the patients had a past history of chronic inflammatory liver disease. Surgical resection was performed in most cases and some patients received postoperative chemotherapy or radiotherapy. The clinicopathologic characteristics and management of this extremely rare disease are also discussed.
Collapse
Affiliation(s)
- Hirokazu Doi
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan.
| | - Norio Horiike
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Atsushi Hiraoka
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Yohei Koizumi
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Yasunori Yamamoto
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Aki Hasebe
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Soichi Ichikawa
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Makoto Yano
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Yasunao Miyamoto
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Tomoyuki Ninomiya
- Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, 790-0024, Japan
| | - Yoshihiro Ishimaru
- Department of Radiology, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Masao Miyagawa
- Department of Radiology, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Kazuhito Takamura
- Department of Surgery, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Hideki Kawasaki
- Department of Surgery, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Teruhiko Kozuka
- Department of Hematology, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Toshiharu Maeda
- Department of Medical Laboratory, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| |
Collapse
|
15
|
Koubaa Mahjoub W, Chaumette-Planckaert MT, Murga Penas EM, Dierlamm J, Leroy K, Delfau MH, Loriau J, Gaulard P, Delchier JC, Zafrani ES, Copie-Bergman C. Primary hepatic lymphoma of mucosa-associated lymphoid tissue type: a case report with cytogenetic study. Int J Surg Pathol 2008; 16:301-7. [PMID: 18387997 DOI: 10.1177/1066896907312671] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Primary hepatic lymphoma of mucosa-associated lymphoid tissue type is extremely rare. Only 38 cases have been reported to date. A case of a 59-year-old man with Helicobacter pylori-resistant gastric ulcers and Buerger disease who was followed up since 1999 is reported. A 2-cm hepatic nodule was incidentally found during partial gastrectomy and corresponded to mucosa-associated lymphoid tissue-type lymphoma without underlying liver disease. Molecular studies showed a clonal immunoglobulin heavy-chain gene rearrangement. Investigations for the mucosa-associated lymphoid tissue lymphoma-associated translocations t(11;18) and t(14;18), as well as the t(3;14)(q27;q32), were negative, whereas trisomy 3 and trisomy 18 were detected.
Collapse
Affiliation(s)
- Wafa Koubaa Mahjoub
- Département de Pathologie, Assistance Publique-Hôpitaux de Paris, Groupe Henri Mondor-Albert Chenevier, Créteil, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Affiliation(s)
- Michael Nalesnik
- Division of Transplant Pathology, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|