Challenges in Diagnosis: Primary Hepatic Lymphoma Presenting as a Space-Occupying Liver Lesion

Non-Hodgkin lymphoma is a heterogeneous group of lymphoid neoplasms, the incidence of which has increased over the past 3 decades. Primary non-Hodgkin lymphoma of the liver is a very rare malignancy. We outline a case describing primary hepatic lymphoma in an 85-year-old woman with a history of breast cancer who presented with generalized weakness and nonspecific symptoms. The patient had normal liver function, serum alpha fetoprotein level, and hemoglobin. A computed tomography scan of the chest, abdomen, and pelvis showed numerous low-attenuation lesions scattered throughout the liver. This case underscores the importance of including primary hepatic lymphoma as a differential diagnosis for space-occupying liver lesions, especially in the setting of normal alpha fetoprotein level.