Lymphoproliferative blood diseases as a cause of liver disease

Abstract

The article presents a review of the literature on liver pathology at lymphoproliferative diseases (LPD) of the blood. Liver dysfunction and/or hepatomegaly may be due to haematological pathology or may develop as a result of specific chemotherapy. Sometimes the isolated liver damage can be the main manifestation of hematological disease. Involvement of the liver worsens the LPD course and prognosis, it causes a reduction in the dose of basic therapy, and even leads to fulminant liver failure. Liver damage can be caused by direct infiltration of the tumor mass, paraneoplastic process, biliary obstruction, hemophagocytic syndrome, activation of chronic viral hepatitis. The following histological types of liver damage are defined: diffuse infiltration of the portal tract, nodular infiltration with the formation of regeneration nodes, sinusoidal infiltration. Each LPD type has its own histological type of liver damage. Paraneoplastic phenomena at LPD are stipulated by the active release of cytokines from the tumor mass and include the bile duct disappearance syndrome (BDDS), peliosis hepatitis and sinusoidal ectasia. The cause of biliary obstruction is most often lymphadenopathy with compression of the extrahepatic bile ducts, less often, primary or secondary lesions of the pancreas. Hemophagocytic syndrome is a potentially lethal condition that occurs with recurrence or late-stage lymphoma. Against the background of treatment with LPD, there is a risk of activation of chronic viral hepatitis B. Nucleoside analogues are recommended for the prevention or treatment of HBV infection. Blood LPD is often associated with HCV infection. Concomitant treatment of LPD and HCV infection with interferon-free regimens is safe and effective. Chemotherapy for the underlying disease usually restores the structure and function of the liver.