title: Non-Hodgkin lymphoma diagnosed by a percutaneous trans-hepatic needle biopsy of portal vein tumor emboli.
abstract: A 58-year-old woman was admitted to our hospital for evaluation of left flank pain. Abdominal computed tomography showed a greatly enlarged splenic tumor with a massive portal vein tumor thrombosis (PVTT). We suspected non-Hodgkin lymphoma (NHL) based on the high values of serum soluble interleukin-2 receptor and lactate dehydrogenase. Because there was no superficial lymph node enlargement, ultrasound-guided percutaneous trans-hepatic needle biopsy was performed to obtain a pathological diagnosis of PVTT, instead of a splenectomy, after the patient had provided informed consent. This procedure was thought to be less invasive than splenectomy. Histologic examination revealed CD20-positive NHL. A complete response was achieved after six courses of R-CHOP and it was confirmed by splenectomy. A PVTT due to NHL is extremely rare as compared with that due to hepatocellular carcinoma, gastric cancer, and colon cancer. However, NHL should be considered in the differential diagnosis for a patient with a PVTT, because B cell-NHL tends to have a good prognosis when rituximab combined chemotherapy is administered. We suggest that a percutaneous trans-hepatic needle biopsy may be useful for diagnosing PVTT due to NHL.
authors.affiliation: Department of Hematology, Hiraka General Hospital.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohyagi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kume
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Shinohara
authors.forename: Satsuki
authors.initials: S
authors.lastname: Takahashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Saito
authors.forename: Masashi
authors.initials: M
authors.lastname: Zuguchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Ken
authors.initials: K
authors.lastname: Saito
authors.forename: Katsu
authors.initials: K
authors.lastname: Hirayama
authors.forename: Naoto
authors.initials: N
authors.lastname: Takahashi
mesh_terms: D001707:Biopsy, Needle; D004617:Embolism / Q000209:etiology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000150:complications / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000473:pathology*; D011169:Portal Vein / Q000473:pathology*