Primary hepatic lymphoma
74 year old patient with a month lasting difficulties (fatigue, upper left abdominal pain, morning nausea, subfebrility, lost weight 5kg in two months). Initially treated with antibiotics (without effect). Sent to the CT exam. US described a 'cystoid translucency "in the left lobe of the liver.
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There is a hypodense left liver lobe mass with another several similar lesions in both kidneys
Primary liver lymphoma (hepatic involvement) is rare and accounts for less than 1% of extranodal lymphoma. The risk factors are viral infections, particularly hepatitis B and C, and Epstein-Barr virus. Women being affected twice as often as men. Symptoms are usually nonspecific with upper left abdominal and epigastric pain, fatigue, weight loss, fever and nausea. Clinically, there is often hepatomegaly and elevated liver function tests.
If lymphoma is suspected (on imaging), the best choice is usually biopsy to confirm the diagnosis, which was also confirmed the diagnosis in this patient.