title: Primary hepatic lymphoma: a challenging diagnosis.
abstract: Introduction. Primary hepatic lymphoma is an unusual malignancy and is very difficult to diagnose promptly. An intrigue case presenting with cholestatic jaundice is reviewed and main disease characteristics are further discussed. Case Report. A 70-year-old male presented with dull right upper quadrant abdominal pain and mild cholestatic jaundice. Initial evaluation revealed mildly elevated liver function tests and normal tumor markers, while imaging with an abdominal CT-scan showed multiple hypodense nodules in both liver lobes. First impression of metastatic deposits from gastrointestinal origin was not confirmed by endoscopic means. After CT-guided biopsy, primary diffuse large B-cells non-Hodgkin lymphoma was revealed. Appropriate chemotherapy improved patient's condition markedly. Discussion. Primary hepatic lymphoma is a rare form of extranodal lymphomas, accounting for less than 1% of all extranodal lymphomas in general. In order to define the condition as PHL, liver has to be the only site of lymphoma occurrence or to be involved in a major degree with minimal nonliver disease. Most PHLs are of B-cell origin with large cells as the main cell type.
authors.affiliation: Pathology Department, Tzaneion General Hospital, 185 36 Piraeus, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Myoteri
authors.affiliation: 2nd Department of Surgery, University Hospital Aretaieion, 115 28 Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Dellaportas
authors.affiliation: Pathology Department, Tzaneion General Hospital, 185 36 Piraeus, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Arkoumani
authors.affiliation: 1st Department of Surgery, Tzaneion General Hospital, 185 36 Piraeus, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Marinis
authors.affiliation: Pathology Department, Tzaneion General Hospital, 185 36 Piraeus, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Zizi-Sermpetzoglou