• MALT lymphoma
• PHL
• chemotherapy
• hepatectomy
• prognosis

• Case report
• Chemotherapy
• Operative
• Primary hepatic lymphoma
• Pyogenic liver abscess

• Deauville score
• FDG PET-CT
• SUVmax
• primary hepatic lymphomas
• response assessment

• case report
• hepatectomy
• mucosal-associated lymphoid tissue
• non-Hodgkin lymphoma
• primary hepatic lymphoma

• actinomycosis
• diffuse large b cell lymphoma
• dlbcl
• liver mass
• primary hepatic lymphoma
• r-chop therapy

Background and Objectives: Primary hepatic lymphoproliferative neoplasms (PHL) are uncommon. This retrospective study is aimed to present the clinicopathological characteristics of PHL and compare to secondary hepatic lymphoproliferative neoplasms (SHL). Materials and Methods: Patients who were diagnosed with lymphoproliferative neoplasms involving the liver between January 2004 and December 2018 at a tertiary medical center in central Taiwan were included. The demographic and clinical data, radiological results and histopathological findings were reviewed and summarized. Results: We analyzed 36 patients comprising 6 PHL patients and 30 SHL patients. The median age at diagnosis tended to be younger in PHL than in SHL (59 vs. 63 years old, p = 0.349). Both entities had a small male predominance. The PHL patients tended to have higher levels of aspartate aminotransferase, alanine transaminase and serum albumin and lower levels of alkaline phosphatase, total bilirubin, γ-glutamyl transferase and lactate dehydrogenase compared with SHL, but there was no significant difference. Multiple mass lesions were the most common radiological finding in both groups. Diffuse large B-cell lymphoma was the predominant subtype in both groups (67% in PHL and 40% in SHL). The PHL patients had a longer median survival than the SHL patients (not reached vs. 3 months, p = 0.003). Conclusions: Although there was no significant difference between PHL and SHL in clinical, laboratory and radiological features, the SHL patients had very poor outcomes with a median survival time of 3 months. Effective therapies are urgently required for these patients.

• liver
• liver function tests
• pathology
• primary hepatic lymphoma
• radiology

• Humans
• Liver Neoplasms
• Male
• Middle Aged
• Retrospective Studies
• Taiwan

The liver as a primary site of lymphoma is rarely seen, they are usually misdiagnosed as hepatocellular carcinoma, etc. In 2017, a review of primary hepatic lymphoma (PHL) was done in immunocompetent diffuse large B-cell lymphoma (DLBCL) patients. Yet questions that include treatment choosing or susceptibility of immunoincompetent patients remain disputable.

To investigate the clinical characteristics of patients with PHL.

We collected PHL cases on PubMed, and extracted demographic and clinicopathological data to perform a systematic analysis. Survival analysis regarding age, lactate dehydrogenase (LDH), liver function abnormality (LFA), and treatment modalities were conducted. The Kaplan-Meier method and Cox regression were used to identify risk factors.

Of 116 PHL patients with DLBCL (62.1%) as the most common subtype. Biopsy methods before surgery produced a 97% positive rate. Progression-free survival (PFS) was significantly shortened in patients with elevated LDH [Hazard ratio (HR): 3.076, 95% confidence interval (CI): 1.207-7.840, P = 0.018] or LFA (HR: 2.909, 95%CI: 1.135-7.452, P = 0.026). Univariate Cox regression analysis suggesting that LDH, liver function, B symptom, hepatosplenomegaly, and lesion were significantly associated with PHL patients survival (P < 0.05). Heavy disease burden was observed in deceased patients. A few PHL patients (3.4%) have slightly higher tumor markers.

PHL patients with elevated LDH and LFA tend to have shorter PFS. Biopsy before treatment in undecided patients with no tumor markers exceeds upper limits has the most essential clinical significance, especially in immunoincompetent patients.

• Primary hepatic lymphoma
• Misdiagnosis
• Biopsy
• Retrospective study

Primary hepatic lymphoma is rare. Clinical and radiological presentations are not specific. The diagnosis is often late. Chronic hepatitis or cirrhosis, especially post-viral C usually precedes primary liver lymphoma. The differential diagnosis arises mainly with other hepatic tumors, such as atypical hypovascular cellular hepatocellular carcinoma when there is liver cirrhosis and with hypovascular hepatic metastases, especially colorectal, stomach and lung metastases. Other differential diagnosis are tuberculosis or sarcoidosis, particularly when there is multiple lesions.

We report the case of a 52-year woman, with a history of hepatitis C infection, presenting liver cirrhosis with multiple hepatic lesions. Radiological aspect was not specific which makes it difficult to distinguish from other hepatic tumors, especially hypovascular liver metastases.

• Cirrhosis
• Hepatic lymphoma
• Imaging

• Hodgkin’s lymphoma
• Imaging biomarkers
• Lymphoma
• Non-Hodgkin’s lymphoma
• Radiogenomics
• Radiomics

Primary hepatic lymphoma is a very uncommon disease. Due to its nonspecific clinical, laboratory, and imaging findings, it is often misdiagnosed. Liver biopsy is required to make a final diagnosis. Chemotherapy is the current gold standard of treatment.

An asymptomatic 65-year-old Caucasian man with Child-Pugh class A cirrhosis presented to our hospital with a nodular lesion seen on a routine surveillance abdominal ultrasound. His physical examination revealed hepatomegaly and no other significant findings. Magnetic resonance imaging of the abdomen showed a voluminous nodule on the left lobe with heterogeneous contrast enhancement. His liver biopsy was compatible with diffuse large B-cell lymphoma. Systemic staging showed no evidence of nodal or bone marrow involvement, confirming the diagnosis of primary hepatic lymphoma. He was treated with chemotherapy. However, he developed febrile neutropenia after one of the cycles and died.

In this article, we report a rare presentation of non-Hodgkin lymphoma and review the current literature on clinical features, diagnosis, and management.

• Diffuse large B-cell lymphoma
• Primary hepatic lymphoma

• SEER
• incidence
• nomogram
• primary hepatic lymphoma
• prognosis
• treatment

Gastrointestinal (GI) lymphomas comprise a group of distinct clinicopathological entities of B- or T- cell type, with primary gastrointestinal Hodgkin lymphoma being extremely uncommon. The GI tract is the predominant site of extranodal non-Hodgkin lymphoma accounting for 30–40% of all extranodal lymphomas. In the Western world, the stomach is the most commonly involved site followed by the small bowel. Several chronic inflammatory and immune-mediated disorders which predispose to accelerated cell turnover may lead to the malignant transformation of gut lymphocytes and ultimately manifest as GI lymphoma. The challenge for the clinical gastroenterologist is that these tumors may have varied presentations, ranging from nonspecific symptoms such as dyspepsia or bloating to abdominal pain, nausea, vomiting, GI bleeding, diarrhea, weight loss or bowel obstruction.

We illustrate the range of presentations of GI lymphoma with examples based on consecutive cases evaluated at our institution over a 6-month period. These cases demonstrate how appropriately directed endoscopic evaluation with biopsies has the potential to provide a definitive diagnosis and allow the patient to proceed to definitive therapy.

The GI tract is the most commonly involved site for extranodal lymphoma with the stomach being most frequently involved organ. Chronic Helicobacter pylori infection, celiac disease, inflammatory bowel disease and autoimmune disorders may predispose to GI lymphoma. This heterogenous group of diseases has varied presentations that may mimic several other GI clinico-pathologic entities. GI lymphomas may be diagnosed with appropriately directed endoscopic evaluation coupled with generous tissue sampling and expert pathologic assessment. Management may range from antibiotic therapy, in the case of Helicobacter pylori-associated gastric MALT lymphoma, to chemotherapy with or without radiation and, in rare instances, surgery. There are presently no guidelines to direct endoscopic surveillance of GI lymphomas following treatment.

• gastric lymphoma
• gastrointestinal neoplasia
• gastrointestinal pathology

• SSAT-1
• amantadine
• biomarkers
• cancer screening and diagnostics
• early detection

To explore the ability of superb microvascular imaging (SMI) in differential diagnosis of focal liver lesions (FLLs) and to compare SMI morphology findings to those of color Doppler ultrasound and enhanced imaging.

Twenty-four patients with 31 FLLs were included in our study, with diagnoses of hemangioma (HE) (n = 17), hepatocellular carcinoma (HCC) (n = 5), metastatic lesions (n = 5), primary hepatic lymphoma (n = 1), focal nodular hyperplasia (FNH) (n = 2), and adenoma (n = 1). Nine lesions were pathologically diagnosed, and 22 lesions were radiologically confirmed, all of which were evaluated by at least two types of enhanced imaging techniques. All patients had undergone SMI. Patients were divided into subgroups based on pathological and radiological diagnoses to analyze SMI manifestations. We also compared the SMI manifestations of the most common malignant FLLs (HCCs and metastatic lesions) with those of the most common benign FLLs (HEs).

HEs were classified into three SMI subgroups: diffuse dot-like type (n = 6), strip rim type (n = 8), and nodular rim type (n = 3). The sizes of the three types of HEs were significantly different (P = 0.00, < 0.05). HCCs were classified into two subgroups: diffuse honeycomb type (n = 2) and non-specific type (n = 3). Four of the metastatic lesions were the strip rim type, and the other metastatic lesion was the thick rim type, which is the same as that of lymphoma. FNH was described as a spoke-wheel type, and adenoma as a diffuse honeycomb type. The SMI types of HCCs and metastatic lesions were significantly different from those of HEs (P = 0.048, < 0.05).

SMI technology enables microvascular evaluation of FLLs without using any contrast agent. For HEs, lesion size may affect SMI performance. SMI is able to provide useful information for differential diagnosis of HCCs and metastatic lesions from HEs.

• Primary hepatic lymphoma
• Hemangioma
• Color doppler ultrasound
• Focal liver lesions
• Superb microvascular imaging

• Adult
• Aged
• Contrast Media/administration & dosage
• Diagnosis, Differential
• Feasibility Studies
• Female
• Focal Nodular Hyperplasia/diagnostic imaging
• Focal Nodular Hyperplasia/pathology
• Hemangioma/diagnostic imaging
• Hemangioma/pathology
• Humans
• Image Enhancement/methods
• Liver/blood supply
• Liver/diagnostic imaging
• Liver/pathology
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/pathology
• Liver Neoplasms/secondary
• Male
• Microvessels/diagnostic imaging
• Middle Aged
• Ultrasonography/methods
• Ultrasonography, Doppler, Color