Abstract
Primary hepatic lymphoma (PHL) is a very rare malignancy and is characterized by liver involvement at presentation with no affectation of the spleen, lymph nodes, peripheral blood, bone marrow, or other tissues until at least 6 months after diagnosis. PHL should be considered in the differential diagnosis in a patient with space-occupying liver lesions and normal levels of alpha-fetoprotein and CEA. A computed tomography (CT) scan is the commonly used modality for staging lymphomas. The widespread use of positron emission tomography/CT results in the improvement in the accuracy of detecting the extent of disease, response evaluation, and prognostication. The liver biopsy, due to its pleomorphic appearances in the needle biopsy specimen, can be very challenging. Current literature favors the combination of chemotherapy as the frontline treatment for its least invasiveness and improved survival. Favorable prognosis of PHL can be obtained by early surgery combined with chemotherapy in strictly selected patients. However, the optimal therapy is still unclear and the outcomes are uncertain.
Similar content being viewed by others
References
Yang XW, Tan WF, Yu WL, Shi S, Wang Y, Zhang YL, Zhang YJ, Wu MC (2010) Diagnosis and surgical treatment of primary hepatic lymphoma. World J Gastroenterol 16:6016–6019
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 (2012) Etiological factors in primary hepatic B-cell lymphoma. Virchows Arch 460:379–387
Li ZM, Zhu YJ, Xia Y, Huang JJ, Jiang WQ (2012) Clinical characteristics of the patients with Hodgkin’s lymphoma involving extranodal sites. Chin J Cancer 31:342–347
Saikia UN, Sharma N, Duseja A, Bhalla A, Joshi K (2010) Anaplastic large cell lymphoma presenting as acute liver failure: a report of two cases with review of literature. Ann Hepatol 9:457–461
El-Sharkawi D, Ramsay A, Cwynarski K, Hughes D, Prentice A, Davies N, Goode A, Wylie P, Malhotra A, Warbey V, Dooley J, McNamara C (2011) Clinico-pathologic characteristics of patients with hepatic lymphoma diagnosed using image-guided liver biopsy techniques. Leuk Lymphoma 52:2130–2134
Noronha V, Shafi NQ, Obando JA, Kummar S (2005) Primary non-Hodgkin’s lymphoma of the liver. Crit Rev Oncol Hematol 53:199–207
Seshadri N, Ananthasivan R, Kavindran R, Srikanth G, Chandra S (2010) Primary hepatic (extranodal) lymphoma: utility of [(18)F]fluorodeoxyglucose-PET/CT. Cancer Imaging 10:194–197
Masood A, Kairouz S, Hudhud KH (2009) Primary non-Hodgkin lymphoma of liver. Curr Oncol 16:74–77
Romaguera JE, Osborne B, Medeiros LJ, Rodriguez J, North L, Sanz-Rodriguez C, Cabanillas F (2001) Primary hepatic lymphoma: favourable outcome after combination chemotherapy. Cancer 92:2023–2029
Kaneko K, Nishie A, Arima F, Yoshida T, Ono K, Omagari J, Honda H (2011) A case of diffuse-type primary hepatic lymphoma mimicking diffuse hepatocellular carcinoma. Ann Nucl Med 25:303–307
Agmon-Levin N, Berger I, Shtalrid M, Schlanger H, Sthoeger ZM (2004) Primary hepatic lymphoma: a case report and review of the literature. Age Ageing 33:637–640
Anthony PP, Sarsfield P, Clarke T (1990) Primary lymphoma of the liver: clinical and pathological features of 10 patients. J Clin Pathol 43:1007–1013
Salmon JS, Thompson MA, Arildsen RC, Greer JP (2006) Non-Hodgkin’s lymphoma involving the liver: clinical and therapeutic considerations. Clin Lymphoma Myeloma 6:273–280
Zucca E, Gregorini A, Cavalli F (2010) Management of non-Hodgkin lymphomas arising at extranodal sites. Ther Ulmsch 67:517–525
Wu SJ, Hung CC, Chen CH, Tien HF (2009) Primary effusion lymphoma in three patients with chronic hepatitis B infection. J Clin Virol 44:81–83
Ohsawa M, Tomita Y, Hashimoto M, Kanno H, Aozasa K (1998) Hepatitis C viral genome in a subset of primary hepatic lymphoma. Mod Pathol 11:471–478
Kim JH, Kim HY, Kang I, Kim YB, Park CK, Yoo JY, Kim ST (2000) A case of primary hepatic lymphoma with hepatitis C liver cirrhosis. Am J Gastroenterol 95:2377–2380
Cecinati V, Arcamone G, Mattia DD, Santoro N, Mantire B (2012) Hepatic non-Hodgkin lymphoma and hepatoblastoma complicating ataxia-telangiectasia. Immunopharmacol Immunotoxicol 34:1–3
Mattar WE, Alex BK, Sherker AH (2010) Primary hepatic burkitt lymphoma presenting with acute liver failure. J Gastrointest Cancer 41:261–263
Lei KI (1998) Primary non-Hodgkin’s lymphoma of the liver. Leuk Lymphoma 29:293–299
Beaty SD, Silva AC, DePetrsi G (2008) Incidental hepatic mass. Am J Roentgenol 190:62–64
Foschi FG, Dall’Aglio AC, Marano G, Lanzi A, Savini P, Piscaglia F, Serra C, Cursaro C, Bernardi M, Andreone P, Stefanini GF (2010) Role of contrast-enhanced ultrasonography in primary hepatic lymphoma. J Ultrasound Med 29:1353–1356
Elsayes KM, Menias CO, Willatt JM, Pandya A, Wiggins M, Platt J (2009) Primary hepatic lymphoma: imaging findings. J Med Imaging Radiat Oncol 53:373–379
Gota VS, Purandare NC, Gujral S, Shah S, Nair R, Rangarajan V (2009) Positron emission tomography/computerized tomography evaluation of primary Hodgkin’s disease of liver. Indian J Cancer 46:237–239
Valladolid G, Adams LL, Weisenberg E, Maker VK, Maker AV (2013) Primary hepatic lymphoma presenting as an isolated solitary hepatic cyst. J Clin Oncol 31:e21–e23
Gatselis NK, Dalekos GN (2011) Education and imaging. Hepatobiliary and pancreatic: primary hepatic lymphoma. J Gastroenterol Hepatol 26:210
Ma YJ, Chen EQ, Chen XB, Wang J, Tang H (2011) Primary hepatic diffuse large B cell lymphoma: a case report: primary hepatic diffuse large B cell lymphoma. Hepat Mon 11:203–205
Cerban R, Gheorghe L, Becheanu G, Serban V, Gheorghe C (2012) Primary focal T-cell lymphoma of the liver: a case report and review of the literature. J Gastrointest Liver Dis 21:213–216
Zafar MS, Aggarwal S, Bhalla S (2012) Complete response to chemotherapy in primary hepatic lymphoma. J Cancer Res Ther 8:114–116
Lee SH, Kim HJ, Mun JS, Oh HC, Lee HW, Choi CH, Kim JW, Do JH, Kim JG, Chang SK, Kim MK (2008) A case of primary hepatic Burkitt’s lymphoma. Korean J Gastroenterol 51:259–264
Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P, Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346:235–342
Mantadakis E, Raissaki M, Tzardi M, Katzilakis N, Chatzimichael A, Kalmanti M (2008) Primary hepatic Burkitt lymphoma. Pediatr Hematol Oncol 25:331–338
Marcus R, Hagenbeek A (2007) The therapeutic use of rituximab in non-Hodgkin’s lymphoma. Eur J Haematol Suppl 67:5–14
Winter MC, Hancock BW (2009) Ten years of rituximab in NHL. Expert Opin Drug Saf 8:223–235
Miyashita K, Tomita N, Oshiro H, Matsumoto C, Nakajima Y, Ito S, Matsumoto K, Fujita H, Ishigatsubo Y (2011) Primary hepatic peripheral T-cell lymphoma treated with corticosteroid. Intern Med 50:617–620
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mastoraki, A., Stefanou, M.I., Chatzoglou, E. et al. Primary Hepatic Lymphoma: Dilemmas in Diagnostic Approach and Therapeutic Management. Indian J Hematol Blood Transfus 30, 150–154 (2014). https://doi.org/10.1007/s12288-013-0263-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12288-013-0263-2