Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9417-9430
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9417
Clinical management and susceptibility of primary hepatic lymphoma: A cases-based retrospective study
Tao Hai, Li-Qun Zou
Tao Hai, Cancer Center, West China Hospital, Chengdu 610041, Sichuan Province, China
Li-Qun Zou, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Hai T designed and performed the research, wrote the paper, contributed to the analysis; Zou LQ designed the research, supervised the report, and provided clinical advice.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University.
Informed consent statement: The ethics committee waived the need for written informed consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Qun Zou, MD, PhD, Chief Doctor, Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. zliqun@hotmail.com
Received: March 31, 2021
Peer-review started: April 1, 2021
First decision: August 18, 2021
Revised: August 21, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: November 6, 2021
ARTICLE HIGHLIGHTS
Research background

In clinical practice, primary hepatic lymphoma (PHL) was is the least considered differential diagnosis of undecided liver masses due to its’ rarity(less than 1% of all diagnosed lymphoma patients), and most of the time, they were misdiagnosed as hepatic cell carcinoma or metastatic malignancies. Surgery was performed based on initial diagnosis, and we believe that proper biopsy before the aggressive operation was better for PHL patients.

Research motivation

The large-scale clinical trial was not suitable for PHL so that a retrospective analysis was needed to address emerged problems.

Research objectives

This study aimed to investigate the clinical characteristics of patients with PHL to avoid misdiagnosis and its’ risk factors.

Research methods

All data was available online. In this retrospective study, baseline characteristics, test results, and follow-up time of 116 patients with PHL were summarized and underwent survival analysis. Statistical analysis was performed using Graphpad 8.0.2 (P < 0.05 were considered statistically significant).

Research results

The diffuse large B-cell lymphoma (62.1%) was the most common subtype. Patients’ survival was significantly shortened by elevated lactate dehydrogenase and liver function abnormality. Heavy disease burden was observed in deceased patients. A few PHL patients (3.4%) have slightly higher tumor markers. Univariate Cox regression also identified B symptom, hepatosplenomegaly, and lesion were risk factors for PHL patients.

Research conclusions

Proper biopsy before treatment in undecided patients with no tumor markers exceeds upper limits is essential to avoid misdiagnosis, especially in immunoincompetent patients.

Research perspectives

The incidence of PHL is increasing according to data from the National Institute of Health. Researchers long discussed the etiology of PHL, and they believed that virus infection, autoimmune diseases (often accompanied with MTX consumption) were most likely to be related to PHL incidence. We are highly second that and suggested that every 5 or 10 years a retrospective review of PHL should be properly done.