Primary hepatic marginal zone B cell lymphoma : a case report and review of the literature

Indian J Surg. 2013 Jun;75(Suppl 1):331-6. doi: 10.1007/s12262-012-0695-1. Epub 2012 Jul 15.

Abstract

Background: Primary hepatic lymphoma (PHL) is a very rare malignancy, and constitutes about 0.016 % of all cases of non-Hodgkin's lymphoma and is often misdiagnosed. The optimal therapy is still unclear and the outcomes are uncertain. Among PHLs, a primary hepatic low-grade marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare.

Methods: We present a case of primary hepatic lymphoma (MALT lymphoma) treated with surgical resection and adjuvant chemotherapy. A 38-year-old Korean man, who was diagnosed with chronic hepatitis B 20 years ago, was admitted for liver biopsy after liver lesions were detected on follow-up computed tomography scan (CT). Liver biopsy revealed the diagnosis of marginal zone B-cell malignant lymphoma (MALT lymphoma). The preoperative clinical staging was IE, given that no additional foci of lymphoma were found anywhere else in the body. The patient underwent left hemihepatectomy. Subsequently, the patient received two cycles of CHOP (cyclophosphamide, adriamycin, vincristine, and prednisone) regimen.

Results: After 15 months of follow-up, the patient is alive and well without any evidence of disease recurrence.

Conclusion: Although the prognosis is variable, good response to early surgery combined with postoperative chemotherapy can be achieved in strictly selected patients.

Keywords: Adjuvant chemotherapy; Chronic hepatitis B; MALT lymphoma; Primary hepatic lymphoma; Surgery.