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Primary hepatic B-cell lymphoma in a child
M H Collins1, A Orazi, M Bauman
1Department of Pathology, James Whitcomb Riley Hospital for Children, Indiana University, School of Medicine, Indianapolis 46202-5200.
The American Journal of Surgical Pathology
|November 1, 1993
Summary
Primary hepatic lymphoma is rare in children. This case highlights a unique calcified B-cell lymphoma in a 12-year-old boy, featuring specific genetic markers and extensive calcification.
Area of Science:
- Pediatric Oncology
- Hepatobiliary Malignancies
- Hematologic Malignancies
Background:
- Primary hepatic lymphoma is an uncommon malignancy in adults and exceedingly rare in pediatric populations.
- Liver tumors in children necessitate a broad differential diagnosis, including rare neoplastic entities.
Observation:
- A 12-year-old male presented with hepatomegaly and jaundice.
- Imaging revealed a calcified intrahepatic mass.
- The mass was diagnosed as a large-cell lymphoma of B-cell origin.
Findings:
- The tumor exhibited bcl-2 protein expression and a near-tetraploid karyotype with t(8;14) and a homogeneously staining region (HSR).
- This represents the fourth documented case of primary hepatic lymphoma in a child and the first with an HSR prior to treatment.
- It is also the first reported human lymphoma with t(8;14) translocation and bcl-2 protein expression.
- Extensive tumor calcification, visualized via computed tomography, is a highly unusual feature for lymphoma.
Implications:
- This case underscores the importance of considering lymphoma in the differential diagnosis of pediatric liver tumors, particularly when serum alpha-fetoprotein levels are normal.
- The unique genetic and radiographic features contribute to the understanding of rare hepatic malignancies.
- Further research into the pathogenesis and treatment of primary hepatic lymphoma in children is warranted.