title: Primary hepatic lymphoma: dilemmas in diagnostic approach and therapeutic management.
abstract: Primary hepatic lymphoma (PHL) is a very rare malignancy and is characterized by liver involvement at presentation with no affectation of the spleen, lymph nodes, peripheral blood, bone marrow, or other tissues until at least 6 months after diagnosis. PHL should be considered in the differential diagnosis in a patient with space-occupying liver lesions and normal levels of alpha-fetoprotein and CEA. A computed tomography (CT) scan is the commonly used modality for staging lymphomas. The widespread use of positron emission tomography/CT results in the improvement in the accuracy of detecting the extent of disease, response evaluation, and prognostication. The liver biopsy, due to its pleomorphic appearances in the needle biopsy specimen, can be very challenging. Current literature favors the combination of chemotherapy as the frontline treatment for its least invasiveness and improved survival. Favorable prognosis of PHL can be obtained by early surgery combined with chemotherapy in strictly selected patients. However, the optimal therapy is still unclear and the outcomes are uncertain.
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece ; Gr. Lambraki 112-114, Piraeus, Athens, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Mastoraki
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Maria Ioanna
authors.initials: MI
authors.lastname: Stefanou
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Chatzoglou
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Danias
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kyriazi
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.affiliation: 4th Department of Surgery, Athens University, Medical School, ATTIKON University Hospital, 1 Rimini Str., 12462 Chaidari, Athens, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Smyrniotis
keywords: Differential diagnosis; Primary hepatic lymphoma; Therapeutic management
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