Primary hepatic lymphoma: A rare case report

Primary hepatic lymphoma (PHL) is a rare clinical entity comprising 0.016% of all cases of non-Hodgkin's lymphoma and 0.4% of extranodal non-Hodgkin's lymphoma and can be missed easily. Here, we report a case of PHL treated with primary hepatic resection followed by an Rituximab Cyclophosphamide Doxorubicin Vincristine Prednisone (R-CHOP) chemotherapy regimen, diagnosed after postoperative biopsy report. The patient presented with complaints of pain abdomen, vomiting, anorexia, and weight loss. She had hepatomegaly and no other significant finding. Blood investigations were unremarkable. Biopsy or fine needle aspiration cytology (FNAC) was not taken before surgery. Contrast-enhanced computed tomography of the abdomen demonstrated well-defined solid mass with central hypodense fluid attenuating area in the liver with a thin pseudocapsule. The differential diagnoses considered were secondary to the liver, hepatocellular carcinoma, and hemangioma. Left hepatectomy with the removal of the middle hepatic vein was performed. The postoperative biopsy was reported as diffuse large B cell lymphoma of the liver.