Department of Internal Medicine, Yeungnam University Medical Center, Daegu 42415, Republic of Korea.
Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
Medicina (Kaunas). 2022 Dec 29;59(1):77. doi: 10.3390/medicina59010077.
Non-Hodgkin's lymphoma (NHL) is the fifth most common hematologic disorder in the United States, and its prevalence has been rising in Western countries. Among the subtypes of NHL, diffuse large B-cell lymphoma (DLBCL) mostly involves the lymph nodes, stomach, and gastrointestinal tract, whereas hepatic involvement of DLBCL is rare. On serologic testing, elevated immunoglobulin G (IgG) levels can be observed in DLBCL; however, elevated IgG levels are mainly observed in autoimmune hepatitis. A targeted-lesion biopsy is required for the diagnosis of DLBCL. Based on a final diagnosis, the patient was treated with rituximab-based chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (R-CHOP). Herein, we report a case of DLBCL mimicking antinuclear antibody-negative autoimmune hepatitis, which was finally diagnosed as DLBCL involving the liver, and was confirmed by liver biopsy.
非霍奇金淋巴瘤（NHL）是美国第五大常见血液系统疾病，其在西方国家的患病率一直在上升。在 NHL 的亚型中，弥漫性大 B 细胞淋巴瘤（DLBCL）主要累及淋巴结、胃和胃肠道，而 DLBCL 肝受累则很少见。在血清学检测中，可观察到 DLBCL 患者 IgG 水平升高；然而，自身免疫性肝炎主要观察到 IgG 水平升高。DLBCL 的诊断需要进行靶向病变活检。根据最终诊断，该患者接受了基于利妥昔单抗的化疗，包括环磷酰胺、多柔比星、长春新碱和泼尼松化疗（R-CHOP）。在此，我们报告一例表现为抗核抗体阴性自身免疫性肝炎样的 DLBCL，最终诊断为 DLBCL 累及肝脏，并通过肝活检得到证实。
