Diffuse Large B Cell Lymphoma Raising Suspicion for an Infection: A Case Report

Area of Science:

• Hepatology
• Oncology
• Diagnostic Imaging

Background:

• Liver lesions present a wide differential diagnosis, including malignancy and infection.
• While imaging aids diagnosis, biopsy remains the gold standard, especially for suspected infections.
• Hepatocellular carcinoma (HCC) can be diagnosed via imaging, but other masses require tissue confirmation.

Observation:

• A 72-year-old male presented with fever, nausea, dark urine, and elevated liver function tests.
• CT revealed an exophytic liver mass near the porta hepatis, with differentials including infection, solid malignancy, or lymphoma.
• Endoscopic and percutaneous biopsy attempts were difficult due to the lesion's location.

Findings:

• Laparoscopic biopsy ultimately diagnosed the liver mass as diffuse large B cell lymphoma (DLBCL).
• This case underscores the diagnostic challenges posed by liver lesions in difficult-to-access locations.

Implications:

• Accurate diagnosis of liver masses is crucial for appropriate treatment planning.
• Laparoscopic biopsy can be a viable option when less invasive methods are challenging.
• This case expands the understanding of DLBCL presentation and diagnostic pathways in hepatobiliary disease.