Major liver resection for non-Hodgkin's lymphoma in an HIV-positive patient: report of a case.
A very unusual clinical presentation of non-Hodgkin's lymphoma (NHL) of the liver is reported herein. The patient was a 35-year-old male who had been HIV-positive since 1987. Following an episode of acute pain in the right upper abdominal quadrant, ultrasonography (US) and computed tomography (CT) were performed, revealing a nodular lesion, 2.5 cm in diameter, localized in the eighth segment of the liver. Despite the fact that the lesion became significantly enlarged over a 6-month period, three repeated percutaneous biopsies proved negative. Finally, his increasing pain and the lack of a definitive diagnosis prompted us to perform a right hepatectomy. The patient had an uneventful postoperative course and is well 1 year after his operation. Establishing a diagnosis of extranodal lymphoma can be difficult, especially in HIV-positive or AIDS patients. Thus, performing a laparotomy is justified to confirm a diagnosis and decide upon the most appropriate treatment. However, in about 10% of these patients, only surgical resection allows for the diagnosis. In accordance with other reports, our experience confirms that, in contrast with AIDS patients, HIV-positive patients have a similar prognosis as non-HIV patients, and are suitable candidates for even major surgical procedures.
Picciocchi
A
A
Department of Surgery, Catholic University School of Medicine, Rome, Italy.
Coppola
R
R
Pallavicini
F
F
Riccioni
M E
ME
Ciletti
S
S
Marino-Cosentino
L M
LM
Marasca
G
G
Ortona
L
L
D000328:Adult; D003937:Diagnosis, Differential; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016483:Lymphoma, AIDS-Related / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008297:Male