HEPATIC LYPHOMA: TWO CASES REPORT

Abstract

Introduction: Hepatic lymphoma is defined as primary when there is an attack on the liver without affecting the spleen, the bone marrow or another lymphatic organ. The primary hepatic attack is a very rare variant estimated at 1% of all extra lymphomas. Case report: We report two cases, the first concerning a patient aged 65 years, without pathological history, admitted for chronic abdominal pain associated with a febrile syndrome, the initial diagnosis revealed a liver tumor at the level of segment I. The patient was operated, the pathological examination of an extemporaneous biopsy concluded to a primitive lymphoma of the liver. The patient was referred to oncology for chemotherapy. Her evolution was satisfactory with a 2-year follow-up. The second patient, 50 years old, without notable pathological history, admitted for generalized jaundice, the physical examination reports a palpable mass in the right hypochondrium. The initial diagnosis revealed the presence of a process involving segment I of the liver, an echo endoscopy showed several mesenteric celiomentaladenopathies and a main biliary tract with stenosis, a sphincterotomy was scheduled, an anatomopathological examination with complementary immunohistochemical study showed a diffuse large cell B lymphoma and the patient was referred to the oncology department. Discussion: Lymphomas of the liver is a rare condition. They predominate in middle- aged adults and males. Clinical presentations are diverse. Radiological aspects and biological disturbances are variable. Treatment modalities are variable, combining surgery, chemotherapy and radiotherapy. Conclusion: The diagnosis of lymphomas of the liver is difficult. The therapeutic decision must take into account the extent of the disease, the general condition of the patient. Chemotherapy remains the cornerstone of treatment.