Primary Liver Lymphoma Presenting as Liver Nodules

Abstract: The liver is usually affected in advanced stages of lymphoproliferative diseases, but primary liver lymphomas (PLLs) are rare. The diagnosis is usually late, especially in patients without identifiable risk factors, with consequent worse prognosis. We report the case of a 59-year-old female with progressive worsening pain in the right hypochondrium and weight loss. She was previously healthy and had a family history of gastrointestinal and gynecologic neoplasms. During the initial investigation, three liver nodules suggestive of liver metastases were found. Nevertheless, no primary neoplasm was identified in a subsequent evaluation with imaging and endoscopic exams. Laboratory exams excluded hepatic infections, metabolic diseases, and acquired immunosuppression. Biopsy of the lesions revealed diffuse large B-cell lymphoma. Lymph node and medullar involvement were excluded, and the diagnosis of PLL was assumed. The patient started chemotherapy with R-CHOP. With this case, we intend to alert for this differential diagnosis of liver nodules, even in the absence of predisposing conditions for lymphoma. We point out the need to define universal diagnosis criteria for this pathology.

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Main Authors: Silva,João Manuel, Saraiva,Rita Ornelas, Simões,Guilherme, Araújo,Catarina, Calinas,Filipe, Coimbra,João
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Gastrenterologia 2021
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000200134
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spelling oai:scielo:S2341-454520210002001342022-01-13Primary Liver Lymphoma Presenting as Liver NodulesSilva,João ManuelSaraiva,Rita OrnelasSimões,GuilhermeAraújo,CatarinaCalinas,FilipeCoimbra,João Liver neoplasms Lymphoma Diffuse large B-cell lymphoma Primary lymphoma Abstract: The liver is usually affected in advanced stages of lymphoproliferative diseases, but primary liver lymphomas (PLLs) are rare. The diagnosis is usually late, especially in patients without identifiable risk factors, with consequent worse prognosis. We report the case of a 59-year-old female with progressive worsening pain in the right hypochondrium and weight loss. She was previously healthy and had a family history of gastrointestinal and gynecologic neoplasms. During the initial investigation, three liver nodules suggestive of liver metastases were found. Nevertheless, no primary neoplasm was identified in a subsequent evaluation with imaging and endoscopic exams. Laboratory exams excluded hepatic infections, metabolic diseases, and acquired immunosuppression. Biopsy of the lesions revealed diffuse large B-cell lymphoma. Lymph node and medullar involvement were excluded, and the diagnosis of PLL was assumed. The patient started chemotherapy with R-CHOP. With this case, we intend to alert for this differential diagnosis of liver nodules, even in the absence of predisposing conditions for lymphoma. We point out the need to define universal diagnosis criteria for this pathology.info:eu-repo/semantics/openAccessSociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.28 n.2 20212021-04-01info:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000200134en10.1159/000507938
institution SCIELO
collection OJS
country Portugal
countrycode PT
component Revista
access En linea
databasecode rev-scielo-pt
tag revista
region Europa del Sur
libraryname SciELO
language English
format Digital
author Silva,João Manuel
Saraiva,Rita Ornelas
Simões,Guilherme
Araújo,Catarina
Calinas,Filipe
Coimbra,João
spellingShingle Silva,João Manuel
Saraiva,Rita Ornelas
Simões,Guilherme
Araújo,Catarina
Calinas,Filipe
Coimbra,João
Primary Liver Lymphoma Presenting as Liver Nodules
author_facet Silva,João Manuel
Saraiva,Rita Ornelas
Simões,Guilherme
Araújo,Catarina
Calinas,Filipe
Coimbra,João
author_sort Silva,João Manuel
title Primary Liver Lymphoma Presenting as Liver Nodules
title_short Primary Liver Lymphoma Presenting as Liver Nodules
title_full Primary Liver Lymphoma Presenting as Liver Nodules
title_fullStr Primary Liver Lymphoma Presenting as Liver Nodules
title_full_unstemmed Primary Liver Lymphoma Presenting as Liver Nodules
title_sort primary liver lymphoma presenting as liver nodules
description Abstract: The liver is usually affected in advanced stages of lymphoproliferative diseases, but primary liver lymphomas (PLLs) are rare. The diagnosis is usually late, especially in patients without identifiable risk factors, with consequent worse prognosis. We report the case of a 59-year-old female with progressive worsening pain in the right hypochondrium and weight loss. She was previously healthy and had a family history of gastrointestinal and gynecologic neoplasms. During the initial investigation, three liver nodules suggestive of liver metastases were found. Nevertheless, no primary neoplasm was identified in a subsequent evaluation with imaging and endoscopic exams. Laboratory exams excluded hepatic infections, metabolic diseases, and acquired immunosuppression. Biopsy of the lesions revealed diffuse large B-cell lymphoma. Lymph node and medullar involvement were excluded, and the diagnosis of PLL was assumed. The patient started chemotherapy with R-CHOP. With this case, we intend to alert for this differential diagnosis of liver nodules, even in the absence of predisposing conditions for lymphoma. We point out the need to define universal diagnosis criteria for this pathology.
publisher Sociedade Portuguesa de Gastrenterologia
publishDate 2021
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452021000200134
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AT araujocatarina primaryliverlymphomapresentingaslivernodules
AT calinasfilipe primaryliverlymphomapresentingaslivernodules
AT coimbrajoao primaryliverlymphomapresentingaslivernodules
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