Clinical characteristics and treatment of primary hepatic lymphoma / 中华肝胆外科杂志

ABSTRACT

Objectives To investigate the clinical features,diagnosis,treatment and prognosis of primary hepatic lymphoma (PHL).Methods A retrospective study was carried out on the clinical records of 6 patients with primary hepatic lymphoma (PHL) treated at the Tianjin Medical University Cancer Hospital from April 2005 to September 2010.The domestic and foreign medical literatures were reviewed.Results For the 6 patients with PHL,the median age was 57 years (range 31-78 years).The male-to-female ratio was 2 1.The most common initial symptoms were abdominal pain and fever.Serum transaminase,lactate dehydrogenase and β2-microglobulin levels were elevated in 4 of 6 patients.For the 3 patients who were tested for alpha-fetoprotein and carcinoembryonic antigen levels,the results were normal.None of the patients had a history of hepatitis or cirrhosis.The diagnosis was non-Hodgkin's lymphoma.A R0 resection was carried out in 1 patient who was lost to follow-up soon after surgery.A R2 resection was carried out in another patient.The remaining 4 patients received liver biopsy.Five patients were treated by CHOP or CHOP-like chemotherapy.A patient died of brain metastases after 8 cycles of chemotherapy,and another patient was lost to follow-up after 1 cycle of chemotherapy.Chemotherapy combined with rituximab were given to the other 3 patients.There was a complete remission in 2 patients after chemotherapy and biotherapy,and these patients were still alive at the last follow-up.Partial remission was achieved in the remaining patient after chemotherapy.The patient was given radiotherapy,but he died finally of tumor progression.Conclusions PHL is an extremely rare lymphoma.Its clinical presentations and imaging manifestations are non-specific.PHL should be considered when the patient has abdominal pain or fever,with a mass in the liver.The ultimate diagnosis depends on histopathologic examination.The pathological type is mainly non Hodgkin's lymphoma,with diffuse large B cell lymphoma.There is still no standard treatment.Surgery,chemotherapy,radiotherapy,targeted therapy and biotherapy can be used.