Premium
Malignant lymphoma can present as hepatobiliary disease
Author(s) -
Harris Alan C.,
BenEzra Jonathan M.,
Contos Melissa J.,
Kornstein Michael J.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19961101)78:9<2011::aid-cncr24>3.0.co;2-z
Subject(s) - medicine , lymphoma , pathology , lymph node , jaundice , h&e stain , immunohistochemistry , bone marrow , gastroenterology
BACKGROUND Liver involvement by non‐Hodgkin's lymphoma usually represents systemic progression of a low grade lymphoma. Sixteen patients without palpable lymphadenopathy who presented with features suggesting hepatic inflammation were found to have non‐Hodgkin's lymphoma involving the liver. METHODS Tissue sections stained with hematoxylin and eosin were examined by light microscopy. Immunohistochemical studies were performed on formalin‐fixed, paraffin embedded tissue to determine phenotype. Patients' medical records were reviewed for clinical details. RESULTS Clinical presentation included fever, jaundice, and elevated liver enzymes. Peripheral lymphadenopathy was absent. Hepatomegaly and splenomegaly were common. Imaging studies revealed a homogeneous pattern of liver involvement without a discrete mass. Histologically, infiltration of the liver was predominantly portal, consisting of large, atypical cells scattered within a background of small lymphoid cells. By immunohistochemistry, it was determined that eight were T‐cell and eight were B‐cell lymphomas. Of the eight patients who had lymph node sampling, three showed involvement by diffuse mixed, small cleaved, and large cell lymphomas. Each of these three involved lymph nodes was located near the liver. Bone marrow infiltration was demonstrated in 10 of the 11 patients in whom it was sampled. Eleven of the 16 patients died 2 days to 31 months after diagnosis, and at last follow‐up, 5 patients were alive 2 weeks to 13 months after diagnosis. CONCLUSIONS Patients with non‐Hodgkin's lymphoma can present with hepatic dysfunction and without peripheral lymphadenopathy. This presentation of lymphoma is associated with extensive disease and an aggressive course. Cancer 1996;78:2011‐9.