Primary hepatic lymphoma in a man with chronic hepatitis C.
We report the case of a middle-aged man who presented de novo with abdominal pain and hepatomegaly and was found to have positive serology for hepatitis C and subsequently a primary hepatic lymphoma. An increased incidence of primary hepatocellular cancer is well characterized in both cirrhotic and non-cirrhotic cases of chronic hepatitis C. The relationship between chronic hepatitis C and primary hepatic lymphoma remains obscure. It has been established that hepatitis C can sustain the clonal B-cell expansion that occurs in associated cryoglobulinaemia, and hepatitis C RNA has been detected within extrahepatic lymphoma tissue. Viral aetiologies for lymphoma are well characterized, such as Epstein-Barr virus (EBV) and human T-cell leukaemia virus (HTLV) I and II. Existing models of chronic infection causing lymphoma within the gastrointestinal tract include that of Helicobacter pylori and mucosa-associated lymphoid tumour of the stomach. Given the relatively low frequency of occurrence it may be prudent to perform a retrospective analysis on past cases of primary hepatic lymphoma in order to determine whether or not hepatitis C was present.
Clarke
G
G
Department of Hepatology, Mater Misericordiae Hospital, Dublin, Ireland.
MacMathuna
P
P
Fenlon
H
H
Callagy
G
G
O'Keane
J C
JC
Carney
D
D
Crowe
J
J
D000912:Antibodies, Neoplasm / Q000032:analysis; D001706:Biopsy; D002908:Chronic Disease; D004797:Enzyme-Linked Immunosorbent Assay; D017809:Fatal Outcome; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D014057:Tomography, X-Ray Computed
D000912:Antibodies, Neoplasm; D018937:Hepatitis C Antibodies; D012367:RNA, Viral