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原发性肝淋巴瘤合并肝硬化 1 例报告

Primary hepatic lymphoma in a patient with cirrhosis: a case report.

机构信息

Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.

Oncology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.

出版信息

J Med Case Rep. 2020 Sep 26;14(1):168. doi: 10.1186/s13256-020-02471-0.

Abstract

BACKGROUND

Primary hepatic lymphoma is a very uncommon disease. Due to its nonspecific clinical, laboratory, and imaging findings, it is often misdiagnosed. Liver biopsy is required to make a final diagnosis. Chemotherapy is the current gold standard of treatment.

CASE PRESENTATION

An asymptomatic 65-year-old Caucasian man with Child-Pugh class A cirrhosis presented to our hospital with a nodular lesion seen on a routine surveillance abdominal ultrasound. His physical examination revealed hepatomegaly and no other significant findings. Magnetic resonance imaging of the abdomen showed a voluminous nodule on the left lobe with heterogeneous contrast enhancement. His liver biopsy was compatible with diffuse large B-cell lymphoma. Systemic staging showed no evidence of nodal or bone marrow involvement, confirming the diagnosis of primary hepatic lymphoma. He was treated with chemotherapy. However, he developed febrile neutropenia after one of the cycles and died.

CONCLUSIONS

In this article, we report a rare presentation of non-Hodgkin lymphoma and review the current literature on clinical features, diagnosis, and management.

摘要

背景

原发性肝淋巴瘤是一种非常罕见的疾病。由于其临床表现、实验室检查和影像学表现均不具有特异性,因此常被误诊。最终诊断需要进行肝活检。化疗是目前的治疗金标准。

病例介绍

一名无症状的 65 岁白人男性,患有 A 级 Child-Pugh 肝硬化,因常规腹部超声检查发现结节性病变而就诊于我院。他的体格检查显示肝肿大,无其他明显异常。腹部磁共振成像显示左叶有一个体积较大的结节,伴有不均匀的对比增强。他的肝活检符合弥漫性大 B 细胞淋巴瘤。全身分期检查未显示淋巴结或骨髓受累的证据,从而确诊为原发性肝淋巴瘤。他接受了化疗。然而,在其中一个周期后他出现发热性中性粒细胞减少,并因此死亡。

结论

本文报告了一例罕见的非霍奇金淋巴瘤表现,并回顾了目前关于其临床特征、诊断和治疗的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d482/7519549/274bb2fb5c52/13256_2020_2471_Fig1_HTML.jpg

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