title: Simultaneous hepatic relapse of non-Hodgkin's lymphoma and hepatocellular carcinoma in a patient with hepatitis C virus-related cirrhosis.
abstract: We report a 66-year-old man with hepatitis C virus (HCV)-related cirrhosis and simultaneous hepatic relapse of non-Hodgkin's lymphoma (NHL) and of hepatocellular carcinoma (HCC). Although the liver is frequently involved by NHL, hepatic colocalization of NHL and HCC is rarely detected by imaging techniques. HCV has been suggested to be lymphotrophic as well as hepatotrophic, and therefore has attracted speculation about a causative role in some cases of lymphoma. The patient had a past history of cutaneous diffuse large B cell lymphoma (DLBCL) in concurrence with HCC 32 months previously. Complete remission (CR) had been maintained for both diseases until February 2004, when ultrasonography and computed tomography (CT) showed multiple liver tumors. Two of these, appearing hyperattenuating in the arterial phase of contrast-enhanced CT, were diagnosed histopathologically as HCC, and treated with radiofrequency ablation. The other tumors, hypoattenuating in the portal phase CT, were diagnosed histopathologically as DLBCL, and treated with cyclophosphamide, tetrahydropyranyl-Adriamycin, vincristine and prednisolone (THP-COP) in combination with rituximab. CR was achieved for both DLBCL and HCC. Given the previously demonstrated immune system tropism and perturbation by HCV, the virus might have contributed to the occurrence of the NHL as well as the HCC.
authors.affiliation: Department of Internal Medicine, Division of Hematology, Kurume University School of Medicine, Fukuoka, Japan. ohtsubo_korenori@kurume-u.ac.jp
authors.forename: Korenori
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: Eijiro
authors.initials: E
authors.lastname: Oku
authors.forename: Rie
authors.initials: R
authors.lastname: Imamura
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Seki
authors.forename: Michitoshi
authors.initials: M
authors.lastname: Hashiguchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Osaki
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yakushiji
authors.forename: Kohji
authors.initials: K
authors.lastname: Yoshimoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ogata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagamatsu
authors.forename: Eiji
authors.initials: E
authors.lastname: Ando
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Shimamatsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Okamura
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D016174:Hepacivirus; D006801:Humans; D008103:Liver Cirrhosis; D008113:Liver Neoplasms / Q000556:secondary*; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology*; D008297:Male