Primary hepatic lymphoma presenting as intravascular lymphomatosis.

A case of primary hepatic lymphoma presenting as intravascular lymphomatosis was diagnosed in a 69-year-old woman who presented with symptoms related to the digestive tract. These symptoms were followed by neurologic disorders, including disturbance of sensation and mentality, and pathologic reflexes suggestive of a broad intracerebral lesion. Computed tomography of the brain showed an ill-defined, low-density area in the bilateral parietotemporal lobes. Autopsy revealed a well-circumscribed hepatic tumor, 6 cm in diameter, and scattered hemorrhagic foci in the cerebral cortexes. Microscopically, the hepatic tumor was a diffuse lymphoma, large cell, of the B-cell type. The small vessels of the brain were found to be packed with lymphoma cells, having caused the florid neurologic manifestations.