Wu M S, Lin J T, Yang P M, Chen Y C, Su I J, Wang T H
Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1993 Mar;92(3):263-6.
Early detection of hepatic lymphoma involvement is of prime importance, as it affects the choice of treatment and the prognosis. However, clinical recognition of these lesions at the time of initial staging or during the course of the disease is difficult because infiltration by lymphoma is usually diffuse rather than focal. We describe a 64-year-old man with a previous history of peripheral T-cell lymphoma involving the lung, skin and inguinal lymph nodes. After six months of chemotherapy resulting in a complete clinical remission, he suffered from an intermittent fever and right upper quadrant pain one week prior to admission. Abdominal ultrasonography and computed tomography disclosed a 6.0 x 5.7 cm heterogeneous mass in the liver. The serum alfafetoprotein level was within the normal limits and an indirect hemagglutinin titer for ameba was negative. The patient was initially treated for a liver abscess until a liver biopsy showed malignant lymphoma. Chemotherapy was initiated and the tumor was remarkable reduced in size, with a final dimension of 2.3 x 2.2 cm before discharge. radiologic patterns of hepatic lymphoma and its differential diagnosis are discussed in this report.