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Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review.

Nagata S, Harimoto N, Kajiyama K - Surg Case Rep (2015)

Bottom Line: No other lymphoid lesions were found during additional postoperative examinations.Therefore, the patient was diagnosed with primary hepatic MALT lymphoma.At the time of this report, the patient was free of disease for 2 years without any additional treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Iizuka Hosipital, Yoshiomachi 3-83, Iizuka, Fukuoka 820-8505 Japan.

ABSTRACT

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. We herein describe the findings in a 74-year-old man with elevated liver enzyme levels. Dynamic computed tomography showed focal biliary dilation and atrophy in the posterior segment, while dynamic magnetic resonance images revealed a small, highly enhanced small mass located at the root of posterior branch of the biliary ducts. As the mass was not detected on abdominal ultrasonography, a biopsy could not be performed. Cholangiocellular carcinoma was suspected, and surgery was performed. However, the surgically resected hepatic tumor was a nodule of aggregated lymphocytes that formed a lymphoepithelial lesion. Immunohistochemical analysis revealed that the lymphoma cells were positive for CD20 and CD79a, but negative for CD3. No other lymphoid lesions were found during additional postoperative examinations. Therefore, the patient was diagnosed with primary hepatic MALT lymphoma. He was also diagnosed with Helicobacter pylori infection, and thus, pylorus eradication was performed. At the time of this report, the patient was free of disease for 2 years without any additional treatment. The present case contributed to the diagnosis and management of this rare disease, as previously published case reports described varying imaging features; it also suggested that preoperative diagnosis was often difficult without biopsy.

No MeSH data available.


Related in: MedlinePlus

Tumor characteristics. a Grossly, the 7-mm white mass along the posterior biliary duct was soft and non-encapsulated. b Histological findings on hematoxylin and eosin staining. The lesion consisted of dense lymphocyte infiltration with some lymph follicles. c and d Small to mid-sized lymphocytes formed lymphoepithelial lesions on some bile capillaries
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Fig3: Tumor characteristics. a Grossly, the 7-mm white mass along the posterior biliary duct was soft and non-encapsulated. b Histological findings on hematoxylin and eosin staining. The lesion consisted of dense lymphocyte infiltration with some lymph follicles. c and d Small to mid-sized lymphocytes formed lymphoepithelial lesions on some bile capillaries

Mentions: Dynamic computed tomography (CT) with drip infusion cholangiography revealed focal dilatation of the biliary ducts and atrophy in the posterior segments of the liver without any observable mass (Fig. 1a, b). The magnetic resonance imaging (MRI) scans, T1- and T2-weighted images, did not show any mass. However, when gadolinium was used as a contrast agent, a 1.5-cm mass located in the area adjacent at the main posterior biliary duct was highly enhanced on T1-weighted images during the arterial phase but demonstrated rapid withdrawal in the portal venous and delayed phases (Fig. 2). Gastroscopic and colonoscopic examinations showed no ulcerative or tumorous lesion. As the mass was not detected on abdominal ultrasonography (US) and it could possibly be a malignant tumor such as cholangiocellular carcinoma, the patient consented to undergo a right hepatectomy with lymph node dissection in the hepatic portal region. Grossly, a 7-mm white mass detected along with the posterior biliary duct was soft and non-encapsulated like a lymph follicle (Fig. 3a).Fig. 1


Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review.

Nagata S, Harimoto N, Kajiyama K - Surg Case Rep (2015)

Tumor characteristics. a Grossly, the 7-mm white mass along the posterior biliary duct was soft and non-encapsulated. b Histological findings on hematoxylin and eosin staining. The lesion consisted of dense lymphocyte infiltration with some lymph follicles. c and d Small to mid-sized lymphocytes formed lymphoepithelial lesions on some bile capillaries
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4580714&req=5

Fig3: Tumor characteristics. a Grossly, the 7-mm white mass along the posterior biliary duct was soft and non-encapsulated. b Histological findings on hematoxylin and eosin staining. The lesion consisted of dense lymphocyte infiltration with some lymph follicles. c and d Small to mid-sized lymphocytes formed lymphoepithelial lesions on some bile capillaries
Mentions: Dynamic computed tomography (CT) with drip infusion cholangiography revealed focal dilatation of the biliary ducts and atrophy in the posterior segments of the liver without any observable mass (Fig. 1a, b). The magnetic resonance imaging (MRI) scans, T1- and T2-weighted images, did not show any mass. However, when gadolinium was used as a contrast agent, a 1.5-cm mass located in the area adjacent at the main posterior biliary duct was highly enhanced on T1-weighted images during the arterial phase but demonstrated rapid withdrawal in the portal venous and delayed phases (Fig. 2). Gastroscopic and colonoscopic examinations showed no ulcerative or tumorous lesion. As the mass was not detected on abdominal ultrasonography (US) and it could possibly be a malignant tumor such as cholangiocellular carcinoma, the patient consented to undergo a right hepatectomy with lymph node dissection in the hepatic portal region. Grossly, a 7-mm white mass detected along with the posterior biliary duct was soft and non-encapsulated like a lymph follicle (Fig. 3a).Fig. 1

Bottom Line: No other lymphoid lesions were found during additional postoperative examinations.Therefore, the patient was diagnosed with primary hepatic MALT lymphoma.At the time of this report, the patient was free of disease for 2 years without any additional treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Iizuka Hosipital, Yoshiomachi 3-83, Iizuka, Fukuoka 820-8505 Japan.

ABSTRACT

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. We herein describe the findings in a 74-year-old man with elevated liver enzyme levels. Dynamic computed tomography showed focal biliary dilation and atrophy in the posterior segment, while dynamic magnetic resonance images revealed a small, highly enhanced small mass located at the root of posterior branch of the biliary ducts. As the mass was not detected on abdominal ultrasonography, a biopsy could not be performed. Cholangiocellular carcinoma was suspected, and surgery was performed. However, the surgically resected hepatic tumor was a nodule of aggregated lymphocytes that formed a lymphoepithelial lesion. Immunohistochemical analysis revealed that the lymphoma cells were positive for CD20 and CD79a, but negative for CD3. No other lymphoid lesions were found during additional postoperative examinations. Therefore, the patient was diagnosed with primary hepatic MALT lymphoma. He was also diagnosed with Helicobacter pylori infection, and thus, pylorus eradication was performed. At the time of this report, the patient was free of disease for 2 years without any additional treatment. The present case contributed to the diagnosis and management of this rare disease, as previously published case reports described varying imaging features; it also suggested that preoperative diagnosis was often difficult without biopsy.

No MeSH data available.


Related in: MedlinePlus