Elghannam Maged T, Hassanien Moataz H, Ameen Yosry A, ELattar Gamal M, ELRay Ahmed A, ELtalkawy Mohammed D, Montasser Ahmed Y
Hepatogastroenterology Department, Theodor Bilharz Research Institute, Giza, Egypt.
Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt.
Egypt Liver J. 2023;13(1):8. doi: 10.1186/s43066-023-00240-4. Epub 2023 Feb 13.
Hepatic involvement is a common extranodal manifestation of common and some rare hematologic malignancies. Although the imaging features of more common hepatic diseases such as hepatocellular carcinoma, metastases, and infection may overlap with those of hepatic hematologic malignancies, combining the imaging features with clinical manifestations and laboratory findings can facilitate correct diagnosis. Imaging has an important role in the diagnosis of hepatic focal lesions.
A case presented with isolated multiple hepatic focal lesions without nodal or spleen enlargement diagnosed only by immunohistochemical study and turned out to be primary hepatic lymphoma (PHL). PHL is rare with roughly 100 described cases and accounts for less than 1% of all non-Hodgkin lymphomas. Osseous involvement adds more challenge to the diagnosis.
Hepatologists must be aware of PHL as it may be confused with more common hepatic diseases, mainly multifocal HCC and/or hepatic metastasis.
肝脏受累是常见和一些罕见血液系统恶性肿瘤常见的结外表现。尽管肝细胞癌、转移瘤和感染等更常见肝脏疾病的影像学特征可能与肝脏血液系统恶性肿瘤的特征重叠，但将影像学特征与临床表现及实验室检查结果相结合有助于正确诊断。影像学在肝脏局灶性病变的诊断中具有重要作用。
1例表现为孤立性多发肝脏局灶性病变，无淋巴结或脾脏肿大，仅通过免疫组化研究确诊，结果为原发性肝脏淋巴瘤（PHL）。PHL较为罕见，约有100例报道，占所有非霍奇金淋巴瘤的比例不到1%。骨受累给诊断增加了更多挑战。
肝病学家必须认识到PHL，因为它可能与更常见的肝脏疾病相混淆，主要是多灶性肝癌和/或肝转移瘤。
