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Int J Hematol (2012) 95:320323 DOI 10.1007/s12185-012-1025-x
CASE REPORT
Primary hepatic lymphoma in a patient with previous rectal adenocarcinoma: a case report and discussion of etiopathogenesis and diagnostic tools
Lucia Raimondo Idalucia Ferrara Alfonso De Stefano Chiara Alessandra Cella
Francesco Paolo DArmiento Giuseppe Ciancia Roberto Moretto
Amalia De Renzo Chiara Carlomagno
Received: 12 July 2011 / Revised: 31 January 2012 / Accepted: 31 January 2012 / Published online: 21 February 2012 The Japanese Society of Hematology 2012
Abstract Primary hepatic lymphoma is an extremely rare malignancy accounting for 0.016% of all cases of non-Hodgkin lymphomas. Approximately 14% of histologies described show a follicular pattern. We report a case of primary hepatic non-Hodgkin lymphoma that developed in a middle-aged woman 3 years after radical treatment (neoadjuvant chemoradiotherapy and surgery) for a rectal adeno-carcinoma. Abdomen ultrasound showed a single nodule in the liver, which raised the issue of differential diagnosis with a metastasis from rectal cancer. After surgical removal of the nodule, histology revealed a primary B cell, stage IE follicular non-Hodgkin lymphoma, conned to the liver; indeed, no foci of lymphoma were found elsewhere in the body.
Keywords Hepatic non-Hodgkin lymphoma Rectal
cancer Second tumour
Introduction
Primary hepatic lymphoma (PHL) is a rare malignancy representing about 0.4% of cases of extranodal non-Hodgkin
lymphoma (NHL) and only 0.016% of all NHL cases [1]. The most common histological type of PHL is diffuse large B cell lymphoma; other histological types account for\5%
of cases [1, 2].
Despite its association with several viral infections (HIV, HBV, HCV and EBV), inammatory diseases (liver cirrhosis and primary biliary cirrhosis), and immunological disorders (autoimmune diseases and immunosuppressive therapy), the pathogenesis of PHL is not yet well established [3, 4]. In fact, although the liver contains lymphoid tissue, host-related factors could render the liver a poor environment for the development of malignant lymphomas [4]. Second malignancies occur in about 6.413.7% of patients treated for solid tumours in 20 years of follow-up, and are correlated with the administration of specic drugs (for example, alkylating agents and topoisomerase II inhibitors) and radiation (for example, in Hodgkin lymphoma treatment) [510]. To our knowledge, ours is the rst report of PHL in a patient previously treated with chemoradiotherapy for rectal cancer.
Case report
A 52-year-old non-smoker woman...