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Non-Hodgkin lymphoma presenting with obstructive jaundice
K V Ravindra1, M D Stringer, K R Prasad
1Hepatobiliary Unit, St James's University Hospital, Leeds, UK.
The British Journal of Surgery
|July 11, 2003
Summary
Non-Hodgkin lymphoma (NHL) can cause obstructive jaundice, a rare condition. Early diagnosis and chemotherapy are key for managing NHL presenting as jaundice, with potential for late biliary strictures.
Area of Science:
- Hepatobiliary Medicine
- Oncology
- Gastroenterology
Background:
- Obstructive jaundice is an uncommon presentation of non-Hodgkin lymphoma (NHL).
- Diagnosing lymphomatous masses in the peripancreatic and hepatic hilar regions can be challenging.
Purpose of the Study:
- To analyze the presentation, diagnosis, and management of obstructive jaundice secondary to NHL.
- To highlight the importance of considering NHL in the differential diagnosis of obstructive jaundice.
Main Methods:
- Retrospective analysis of patients with obstructive jaundice due to NHL at a tertiary hepatobiliary unit.
- Review of diagnostic procedures including laparotomy, hepatic trisectionectomy, and percutaneous biopsy.
- Evaluation of treatment outcomes, primarily chemotherapy.
Main Results:
- Nine patients (6 adults, 3 children) with NHL presenting with obstructive jaundice were identified over 7 years.
- Lymphomatous masses were located at the hepatic hilum (6 patients) or peripancreatic area (3 patients).
- Chemotherapy achieved complete remission in 4 patients, partial remission in 3, and no response in 1; 2 patients developed late benign biliary strictures.
Conclusions:
- Non-Hodgkin lymphoma should be considered in the differential diagnosis of obstructive jaundice in both adults and children.
- Non-operative diagnostic techniques should be prioritized for suspected NHL causing jaundice.
- Chemotherapy is the primary treatment modality for NHL-induced obstructive jaundice, with awareness of potential late complications like biliary strictures.