Primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type: Case report and review of the literature

Department of Gastroenterology, Ehime Prefectural Central Hospital, Ehime, Japan.
International journal of hematology (Impact Factor: 1.92). 10/2008; 88(4):418-23. DOI: 10.1007/s12185-008-0153-9
Source: PubMed


A primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) is very rare. We found a solitary mass 27 mm in size in the left lobe of the liver of a 58-year-old Japanese man with a history of hepatitis-C infection. Based on the results of imaging studies, the tumor was diagnosed as a hepatocellular carcinoma (HCC). The left lobe of the liver was lobectomized and microscopic findings showed that the tumor was a hepatic MALT lymphoma, while immunohistochemistry showed it to be positive for CD20 and CD79a. In a fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning (FDG-PET CT) before surgery, the tumor was revealed to have a high standardized uptake value (SUV) for FDG. The patient received chemotherapy after surgery. To the best of our knowledge, 45 cases had been reported with a mean age for all patients of 61.4 years. The pathogenesis remains unclear, although half of the patients had a past history of chronic inflammatory liver disease. Surgical resection was performed in most cases and some patients received postoperative chemotherapy or radiotherapy. The clinicopathologic characteristics and management of this extremely rare disease are also discussed.

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    • "The etiopathogenesis of HPL remains unclear, although 27% of the patients had chronic liver diseases including HBV- or HCV-related liver cirrhosis, and moreover, 23% had autoimmune disorders, such as PBC, in extrahepatic organs [26]. In terms of background disorders, this figure is comparable with that of MALT lymphoma, where half of the patients have chronic inflammatory liver diseases including autoimmune disorders [11,21,27,28]. The similarity would imply the common pathogenesis of these two conditions. "
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    ABSTRACT: Hepatic pseudolymphoma (HPL) and primary hepatic marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) are rare diseases and the differential diagnosis between these two entities is sometimes difficult. We herein report a 56-year-old Japanese woman who was pointed out to have a space occupying lesion in the left lateral segment of the liver. Hepatitis viral-associated antigen/antibody was negative and liver function tests including lactic dehydrogenase, peripheral blood count, tumor markers and soluble interleukin-2 receptor were all within normal limit. Imaging study using computed tomography and magnetic resonance imaging were not typical for hepatocellular carcinoma, cholangiocarcinoma, or other metastatic cancer. Fluorodeoxyglucose-positron emission tomography examination integrated with computed tomography scanning showed high standardized uptake value in the solitary lesion in the liver. Under a diagnosis of primary liver neoplasm, laparoscopic-assisted lateral segmentectomy was performed. Liver tumor of maximal 1.0 cm in diameter was consisted of aggregation of lymphocytes of predominantly B-cell, containing multiple lymphocyte follicles positive for CD10 and bcl-2, consistent with a diagnosis of HPL rather than MALT lymphoma, although a definitive differentiation was pending. The background liver showed non-alcoholic fatty liver disease/early non-alcoholic steatohepatitis. The patient is currently doing well with no sign of relapse 13 months after the surgery. Since the accurate diagnosis is difficult, laparoscopic approach would provide a reasonable procedure of diagnostic and therapeutic advantage with minimal invasiveness for patients. Considering that the real nature of this entity remains unclear, vigilant follow-up of patient is essential.
    World Journal of Surgical Oncology 01/2011; 9:3. DOI:10.1186/1477-7819-9-3 · 1.41 Impact Factor
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    • "The most common histological type is diffuse large Bcell lymphoma (DLBCL) [2] [3]. Other histology has been reported extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type [4] [5], follicular lymphoma [6], Burkitt's lymphoma [7] or Hodgkin's lymphoma "
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    ABSTRACT: Primary hepatic extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) type lymphoma is very rare disease. We reported two cases of primary hepatic MALT lymphoma associated with chronic inflammatory disorder. One case was a 74-year-old female complicated with asymptomatic primary biliary cirrhosis. Another case was a 73-year-old man presented with a mild hepatitis C. Both biopsy specimens showed diffuse infiltration of small atypical lymphoid cells that were phenotypically CD20+, CD79a+, CD5- and CD10-. Patients were received r-THP-COP (rituximab, pirarubicin, cyclophosphamide, vincristine, predonisolone) and achieved complete remission. Primary hepatic MALT lymphoma may be strongly associated with chronic inflammation, especially hepatitis C virus infection. However, the relationship between primary hepatic MALT lymphoma and PBC is still controversial, because the lymphoma complicated with PBC is extremity rare and there is no immunological and genetical study about it. We discuss the pathogenesis and clinical manifestation of this rare disease.
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    ABSTRACT: Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare, and the etiology of disease is not fully understood. We present herein the case of a primary hepatic MALT lymphoma with Helicobacter pylori and hepatitis C virus infection. A 71-year-old male was admitted to our institution to undergo a precise evaluation of a hepatic tumor incidentally detected during a computed tomography (CT) scan for chest examination. Dynamic CT showed faint enhancement during the arterial phase. The gadoxetate disodium-enhanced magnetic resonance imaging showed a hyper-intensity on the arterial phase and low intensity during the late and hepatocyte phases. Liver biopsy specimen showed small to intermediate size atypical lymphocytes with positive CD20 immunohistochemical staining. It was finally diagnosed as primary hepatic MALT lymphoma. FDG-PET/CT showed faintly increased uptake with a maximum standardized uptake value of 4.6, and did not show other pathological uptake. We present the rare case of primary hepatic MALT lymphoma and discussed the etiology of this disease.
    Clinical Journal of Gastroenterology 04/2013; 6(2). DOI:10.1007/s12328-013-0362-5
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