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Maligne Lymphome in der Leber

Neue diagnostische Algorithmen

Malignant lymphomas of the liver: new diagnostic algorithms

Der Pathologe volume 27, pages 263–272 (2006)Cite this article

Zusammenfassung

Primäre Lymphome der Leber sind seltene Malignome, die mit einer chronischen Virushepatitis, Immunsuppression oder Autoimmunerkrankungen assoziiert sein können, wohingegen sekundäre hepatische Lymphome als Ausdruck einer disseminierten Lymphomerkrankung vergleichsweise oft beobachtet werden. In abnehmender Häufigkeit finden sich diffuse großzellige B-Zell-Lymphome, chronische lymphatische B-Zell-Leukämien, Hodgkin-Lymphome, periphere T-Zell-Lymphome, follikuläre Lymphome und Marginalzonenlymphome. Aufgrund charakteristischer histomorphologischer Infiltrationsmuster ist es auch in Leberbiopsaten möglich, B-Zell-Lymphome durch eine Selektion immunhistologischer Marker zeit- und kosteneffektiv einzugrenzen, während bei T-Zell-Lymphomen nicht selten ergänzende molekularpathologische Untersuchungen notwendig sind. Differenzialdiagnostisch müssen hepatische Lymphome zum einen von entzündlichen Leber- und Gallenwegserkrankungen, zum anderen z. B. von undifferenzierten Karzinomen, inflammatorischen myofibroblastären Tumoren sowie histiozytären und dendritischen Tumoren abgegrenzt werden.

Abstract

Primary hepatic lymphomas represent rare neoplasms, which are partly observed in association with chronic viral hepatitis, immunosuppression and autoimmune diseases. In contrast, secondary hepatic lymphomas are much more frequent and represent disseminated disease. Lymphomas involving the liver include, with decreasing frequency, diffuse large B-cell lymphoma, small lymphocytic lymphoma, Hodgkin’s lymphoma, peripheral T-cell lymphoma, follicular lymphoma and extranodal marginal zone B-cell lymphoma. Many B-cell lymphomas in the liver reveal a characteristic infiltration pattern allowing a rapid and cost-effective diagnosis based on focused immunohistochemical analyses. In contrast, most T-cell lymphomas show a more diverse morphology, which is sometimes difficult to differentiate from a reactive condition. Therefore, additional molecular analyses are frequently necessary. The differential diagnosis includes hepatitis and inflammatory bile duct diseases, undifferentiated carcinoma, inflammatory myofibroblastic tumor as well as histiocytic and dendritic cell neoplasms.

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Affiliations

  1. Pathologisches Institut, Universitätsklinikum, Im Neuenheimer Feld 220/221, 69120, Heidelberg

    T. Longerich &  P. Schirmacher

  2. Institut für Pathologie, Universität zu Köln

    H. P. Dienes

  3. Institut für Pathologie, Konsultations- und Referenzzentrum für Lymphknoten- und Hämatopathologie, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin

    H. Stein & C. Loddenkemper

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  1. T. Longerich
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  2. P. Schirmacher
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  3. H. P. Dienes
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  4. H. Stein
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  5. C. Loddenkemper
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Correspondence to P. Schirmacher.

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Longerich, T., Schirmacher, P., Dienes, H.P. et al. Maligne Lymphome in der Leber. Pathologe 27, 263–272 (2006). https://doi.org/10.1007/s00292-006-0838-x

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  • DOI: https://doi.org/10.1007/s00292-006-0838-x

Schlüsselwörter

  • Leber
  • Lymphom
  • Leukämie
  • Immunhistologie
  • Molekularpathologie

Keywords

  • Liver
  • Lymphoma
  • Leukemia
  • Immunohistochemistry
  • Molecular pathology