Hepatic Involvement of Diffuse Large B-Cell Lymphoma Mimicking Antinuclear Antibody-Negative Autoimmune Hepatitis Diagnosed by Liver Biopsy

Medicina (Kaunas). 2022 Dec 29;59(1):77. doi: 10.3390/medicina59010077.

Abstract

Non-Hodgkin's lymphoma (NHL) is the fifth most common hematologic disorder in the United States, and its prevalence has been rising in Western countries. Among the subtypes of NHL, diffuse large B-cell lymphoma (DLBCL) mostly involves the lymph nodes, stomach, and gastrointestinal tract, whereas hepatic involvement of DLBCL is rare. On serologic testing, elevated immunoglobulin G (IgG) levels can be observed in DLBCL; however, elevated IgG levels are mainly observed in autoimmune hepatitis. A targeted-lesion biopsy is required for the diagnosis of DLBCL. Based on a final diagnosis, the patient was treated with rituximab-based chemotherapy, including cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy (R-CHOP). Herein, we report a case of DLBCL mimicking antinuclear antibody-negative autoimmune hepatitis, which was finally diagnosed as DLBCL involving the liver, and was confirmed by liver biopsy.

Keywords: anti-nuclear antibody negative autoimmune hepatitis; diffuse large B-cell lymphoma; liver biopsy; liver cirrhosis.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Antinuclear
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biopsy
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Hepatitis, Autoimmune* / diagnosis
  • Hepatitis, Autoimmune* / drug therapy
  • Humans
  • Immunoglobulin G
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Rituximab / therapeutic use
  • Vincristine / therapeutic use

Substances

  • Antibodies, Antinuclear
  • Rituximab
  • Vincristine
  • Cyclophosphamide
  • Doxorubicin
  • Immunoglobulin G