Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2018; 10(2): 347-351
Published online Feb 27, 2018. doi: 10.4254/wjh.v10.i2.347
Primary hepatic peripheral T-cell lymphoma associated with Epstein-Barr viral infection
Daryl Ramai, Emmanuel Ofori, Sofia Nigar, Madhavi Reddy
Daryl Ramai, Emmanuel Ofori, Sofia Nigar, Madhavi Reddy, Division of Gastroenterology and Hepatology, Brooklyn Hospital Center, Brooklyn, NY 11201, United States
Daryl Ramai, Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada 999166, West Indies
Author contributions: Ramai D, Ofori E and Nigar S designed the report; Ramai D and Reddy M collected the patient’s clinical data; Ramai D wrote the paper; Ofori E, Nigar S and Reddy M edited the manuscript for intellectual content.
Informed consent statement: Regarding consent, we contacted our patient's spouse who reported that the patient has since passed.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
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: Daryl Ramai, MD, Research Fellow, Division of Gastroenterology and Hepatology, Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, United States. dramai@sgu.edu
Telephone: +1-718-2508867 Fax: +1-718-250758
Received: October 31, 2017
Peer-review started: November 1, 2017
First decision: December 1, 2017
Revised: December 20, 2017
Accepted: January 23, 2018
Article in press: January 24, 2018
Published online: February 27, 2018
Abstract

Primary hepatic peripheral T-cell lymphoma (H-PTCL) is one of the rarest forms of non-Hodgkin lymphoma. We report a patient who presented with worsening jaundice, abdominal pain, and vomiting. Laboratory values were significant for elevated total bilirubin, alkaline phosphatase, and liver aminotransferases. Following a liver biopsy, histopathology revealed several large dense clusters of atypical T-lymphocytes which were CD2+, CD3+, CD5+, CD7-, CD4+, CD8-, CD56-, CD57-, CD30+ by immunohistochemistry. The proliferation index was approximately 70% by labeling for ki67/mib1. The above histological profile was consistent with peripheral T-cell lymphoma of the liver. Epstein-Barr viral serology indicated a remote infection, a likely risk factor for PTCL. Bone marrow biopsy was negative for malignancy, further supporting hepatic origin.

Keywords: Primary lymphoma, Liver cancer, Non-Hodgkin’s lymphoma, T-cell lymphoma

Core tip: Primary hepatic peripheral T-cell lymphoma (H-PTCL) is one of the rarest forms of non-Hodgkin lymphoma. We report a patient who presented with worsening jaundice, abdominal pain, and vomiting. Laboratory values were significant for elevated total bilirubin, alkaline phosphatase, and liver aminotransferases. Liver biopsy followed by histopathology confirmed the diagnosis of H-PTCL. Furthermore, bone marrow biopsy was negative for malignancy, further supporting hepatic origin. Our patient’s medical history reported a prior Epstein-Barr viral infection, a risk factor for H-PTCL. In the setting of risk factors, H-PTCL should be born in mind when a patient presents with symptoms of malignancy, and an enlarged and infiltrating liver.