Primary Liver Sinusoidal Non-Hodgkin's Lymphoma Presenting as Acute Liver Failure

Aabha Nagral; Ajay Jhaveri; Vilesh Kalthoonical; Ganapathi Bhat; Pravin Mahajan; Anita Borges

doi:10.1016/j.jceh.2015.10.007

Primary Liver Sinusoidal Non-Hodgkin's Lymphoma Presenting as Acute Liver Failure

J Clin Exp Hepatol. 2015 Dec;5(4):341-3. doi: 10.1016/j.jceh.2015.10.007. Epub 2015 Nov 24.

Authors

Aabha Nagral¹, Ajay Jhaveri¹, Vilesh Kalthoonical², Ganapathi Bhat³, Pravin Mahajan⁴, Anita Borges⁴

Affiliations

¹ Department of Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, India.
² Department of Nephrology, Jaslok Hospital and Research Centre, Mumbai, India.
³ Department of Medical Oncology, Jaslok Hospital and Research Centre, Mumbai, India.
⁴ Department of Histopathology, S. L. Raheja Hospital, Mumbai, India.

Abstract

We describe a case of a middle-aged woman, who presented to us with fever, anorexia, abdominal distension from a massive hepatomegaly, low hemoglobin, and acute liver failure. A liver biopsy revealed B cell non-Hodgkin's lymphoma predominantly in the sinusoids with CD10, CD20, and Bcl-2 positive on immunohistochemistry. She initially responded well to chemotherapy but succumbed 6 months later to the recurrence of disease. Sinusoidal non-Hodgkin's lymphoma of the liver should be considered in the differential diagnosis of a patient with large hepatomegaly presenting with acute liver failure.

Keywords: AFP, alpha feto protein; ALT, alanine aminotransferase; AST, aspartate aminotransferase; B cell; Bcl 2, B cell lymphoma 2; CD, cluster differentiation; CECT, contrast enhanced computed tomography; CHOP, cyclophosphamide hydroxydaunorubicin (adriyamycin) oncovin (vincristine) prednisolone; CK, cyto keratin; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HIV, human immunodeficiency virus; IgM, immunoglobulin M; NHL, non-Hodgkins lymphoma; PET CT, positron emission tomography–computed tomography; WBC, white blood cells; chemotherapy; hepatocyte; liver failure.