Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2015; 21(45): 12981-12986
Published online Dec 7, 2015. doi: 10.3748/wjg.v21.i45.12981
Coexistence of hepatoma with mantle cell lymphoma in a hepatitis B carrier
Mu-Hsien Lee, Yu-Ching Lin, Hao-Tsai Cheng, Wen-Yu Chuang, Hsin-Chih Huang, Hsiao-Wen Kao
Mu-Hsien Lee, Hao-Tsai Cheng, Hsin-Chih Huang, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan
Yu-Ching Lin, Department of Intervention and Imaging, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei 105, Taiwan
Wen-Yu Chuang, Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei 105, Taiwan
Hsiao-Wen Kao, Department of Hematology-Oncology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei 105, Taiwan
Author contributions: Lee MH wrote the paper; Cheng HT, Huang HC and Kao HW designed the study; Lin YC reviewed the images; and Chuang WY reviewed the pathological reports.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Chang Gung Hospital (No. 104-5688B).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to enrollment in the study.
Conflict-of-interest statement: The authors have no financial disclosures to declare and no conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Hao-Tsai Cheng, MD, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 5 Fu-Shin Street, Kweishan, Taoyuan 333, Taiwan. howardandbetty@yahoo.com.tw
Telephone: +886-3-3281200-8108 Fax: +886-3-3272236
Received: June 28, 2015
Peer-review started: June 28, 2015
First decision: July 19, 2015
Revised: August 24, 2015
Accepted: September 30, 2015
Article in press: September 30, 2015
Published online: December 7, 2015
Abstract

The coexistence of hepatocellular carcinoma (HCC) and non-Hodgkin’s lymphoma (NHL) in the liver is rare. Reports show that these patients have cirrhotic livers or hepatitis virus infections before they develop HCC and NHL. We present a patient with hepatitis B virus infection who was transferred to our hospital with a newly detected liver mass; abdominal computed tomography examination showed one hypodense mass of 7 cm in diameter and multiple mesenteric and mediastinal lymph nodes. A liver tumor biopsy showed a hepatoma, and the pathologic findings from an inguinal lymph node excision showed mantle cell lymphoma. An immunohistochemical stain confirmed that the atypical lymphoid cells within the HCC were positive for the CD20, CD5 and cyclin D1 antigens. Taking these findings into account, the hepatic tumor was determined to be a HCC infiltrated by mantle cell lymphoma.

Keywords: Hepatocellular carcinoma, Mantle cell lymphoma, Hepatitis B virus

Core tip: The coexistence of hepatocellular carcinoma (HCC) and non-Hodgkin’s lymphoma in the liver is rare. The risk factors include hepatitis virus infection, liver cirrhosis and antineoplastic therapy. This case report presents a rare case of HCC and mantle cell lymphoma in the liver. Only hepatitis B virus infection is identified. “Tumor to tumor metastasis” is noted in the pathologic findings. The literature is also reviewed.