Primary Liver Lymphoma Presenting as Liver Nodules

Area of Science:

• Hepatology
• Oncology
• Hematology

Background:

• Primary liver lymphomas (PLLs) are rare malignancies.
• Liver involvement is common in advanced lymphoproliferative diseases, but PLLs are infrequent.
• Late diagnosis of PLLs, particularly in patients without risk factors, leads to poorer prognoses.

Observation:

• A 59-year-old female presented with right upper quadrant pain and weight loss.
• Initial investigations revealed liver nodules mimicking metastases, but no primary tumor was found.
• Exclusion of infections, metabolic diseases, and immunosuppression was confirmed through laboratory tests.

Findings:

• Liver biopsy confirmed diffuse large B-cell lymphoma.
• Absence of lymph node or medullary involvement established the diagnosis of PLL.
• The patient initiated chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).

Implications:

• This case highlights PLL as a critical differential diagnosis for liver nodules.
• It emphasizes the importance of considering PLL even without typical lymphoma risk factors.
• The study underscores the need for standardized diagnostic criteria for primary liver lymphoma.