Presentation
A month of lasting difficulties (fatigue, upper left abdominal pain, morning nausea, low-grade fever, lost weight 5kg in two months). Initially treated with antibiotics (without effect). Ultrasound demonstrates a 'cystoid translucency "in the left lobe of the liver.
Patient Data
There is a hypodense left liver lobe mass with another several similar lesions in both kidneys.
Rapid enlargement of the liver mass and also the lesions in the kidneys and pancreas.
Marked decrease in size of the hepatic mass and the kidney and renal masses.
Case Discussion
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 are 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.
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