[Rupture of hepatic lesion of diffuse large B-cell lymphoma following immunochemotherapy]

A 51-year-old woman presented to the outpatient clinic with appetite loss and abdominal pain that had persisted for 1 month. Computed tomography (CT) showed a bulky tumor in the right liver, with hepatosplenomegaly and lymphadenopathy in several para-aortic lymph nodes. The diagnosis of diffuse large B-cell lymphoma was confirmed by a biopsy of a submucosal tumor in the stomach. Bone marrow invasion by lymphoma cells was observed. On day5 after a rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) regimen was initiated, epigastralgia and right hypochondralgia were noted. On day6, severe anemia (hemoglobin level, 4.2 g/dl) developed. Repeat CT showed a low-density area surrounding the hepatic tumor caused by tumor lysis, and hepatic tumor rupture was suspected. Transfusion was performed, and no signs of recurrence of bleeding were noted after the procedure. On day21, angiography of the hepatic artery showed no signs of bleeding. After two cycles of R-CVP therapy and eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, partial remission was achieved. In this report, we present a rare case of patient survival following hepatic tumor rupture associated with hepatic lymphoma after treatment.