Korean J Med.  2018 Jun;93(3):285-290. 10.3904/kjm.2018.93.3.285.

A Hepatic Lymphoma Mimicking Multiple Liver Metastases or an Intrahepatic Cholangiocarcinoma

• Oh JH
• Choi MS
• Shin DH
• Kim SJ
• Kang TU
• Koh YH

• KMID: 2435167
• DOI: http://doi.org/10.3904/kjm.2018.93.3.285

Abstract

A primary hepatic lymphoma (PHL) is a rare malignancy; misdiagnosis and mistreatment are very common. We report the case of a 56-year-old female who presented with a 2-week history of upper abdominal pain. She exhibited no risk factors for hepatocellular carcinoma (HCC) and her serum tumor marker levels were normal. A computed tomography scan and gadolinium-enhanced magnetic resonance imaging of the liver revealed multiple liver masses, suggestive of multiple liver and lung metastases or an intrahepatic cholangiocarcinoma with lung metastasis. A diagnosis of PHL (a diffuse large B cell lymphoma) was confirmed by biopsy followed by immunohistochemistry. This case emphasizes that a PHL must be considered in the differential diagnosis of space-occupying liver lesions in patients with no risk factors for HCC and normal levels of serum tumor markers. It is notable that neither B cell lymphoma symptoms nor an elevated lactate dehydrogenase level were apparent in this case. We thus report a case of PHL mimicking multiple liver metastases or an intrahepatic cholangiocarcinoma, and we review the literature.

Keyword

Liver neoplasm; Lymphoma, Non-hodgkin; Lymphoma, Large B-Cell, Diffuse; Primary hepatic lymphoma

MeSH Terms

Abdominal Pain
Biomarkers, Tumor
Biopsy
Carcinoma, Hepatocellular
Cholangiocarcinoma*
Diagnosis
Diagnosis, Differential
Diagnostic Errors
Female
Humans
Immunohistochemistry
L-Lactate Dehydrogenase
Liver Neoplasms
Liver*
Lung
Lymphoma*
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Magnetic Resonance Imaging
Middle Aged
Neoplasm Metastasis*
Risk Factors
Biomarkers, Tumor
L-Lactate Dehydrogenase