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酷似急性暴发性肝炎的原发性肝弥漫性大B细胞淋巴瘤:一例报告并文献复习

Primary Hepatic Diffuse Large B-cell Lymphoma Mimicking Acute Fulminant Hepatitis: A Case Report and Review of the Literature.

作者信息

El Nouwar Ricardo, El Murr Tony

机构信息

Department of Internal Medicine, Middle East Institute of Health, Faculty of Medical Science, Lebanese University, Hadath, Lebanon.

出版信息

Eur J Case Rep Intern Med. 2018 Jun 26;5(6):000878. doi: 10.12890/2018_000878. eCollection 2018.

Abstract

UNLABELLED

Primary hepatic lymphoma (PHL) is a rare variant of non-Hodgkin's lymphoma. Diffuse hepatic involvement is uncommon and therefore presentation as progressive hepatitis or acute fulminant hepatic failure is rare. Acute onset of signs and symptoms can mimic a variety of infectious and inflammatory disorders, thus delaying the diagnosis. A high index of suspicion and liver biopsy early in the course of liver dysfunction may establish the diagnosis and allow rapid initiation of chemotherapy to prevent a fatal outcome. In this report, we describe a rare case of fulminant primary hepatic diffuse large B-cell lymphoma in a 55-year-old woman who died 2 weeks after admission, before the initiation of chemotherapy.

LEARNING POINTS

Primary hepatic lymphoma (PHL) is a rare yet serious disease which should be suspected in every case presenting as hepatitis with unclear aetiology.A liver biopsy should be performed as early as possible when PHL is suspected.Failure to detect PHL early can result in rapid deterioration and death within 2 weeks of presentation.

摘要

未标注

原发性肝淋巴瘤(PHL)是非霍奇金淋巴瘤的一种罕见变体。弥漫性肝脏受累并不常见,因此表现为进行性肝炎或急性暴发性肝衰竭的情况很少见。症状和体征的急性发作可模仿多种感染性和炎症性疾病,从而延误诊断。在肝功能障碍病程早期保持高度怀疑并进行肝活检,可能确立诊断并允许迅速开始化疗以防止致命结局。在本报告中,我们描述了一例罕见的暴发性原发性肝弥漫性大B细胞淋巴瘤病例,患者为一名55岁女性,入院后2周在开始化疗前死亡。

学习要点

原发性肝淋巴瘤(PHL)是一种罕见但严重的疾病,对于每例病因不明的肝炎病例均应怀疑该病。怀疑PHL时应尽早进行肝活检。早期未检测到PHL可导致在出现症状后2周内迅速恶化和死亡。

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