Abstract
BackgroundBecause of the rarity of primary hepatic lymphomas, diagnosis of this disease entity may often be difficult, and performing a liver biopsy is the only way to establish a definitive diagnosis. Recently, endoscopic ultrasound-guided liver biopsy has emerged as a safe technique for obtaining liver tissue. However, there is no report on the use of endoscopic ultrasound-guided liver biopsy for diagnosing primary hepatic lymphomas.Case presentationAn 85-year-old Asian man was admitted to our hospital because of multiple liver lesions without any identifiable primary tumor or extrahepatic lymphadenopathy. Serum tumor markers, including alpha-fetoprotein, were in the normal range. We provisionally diagnosed the patient with a cancer of unknown primary origin with liver metastases. An endoscopic ultrasound-guided fine needle liver biopsy of the tumor in the left lobe of the liver was performed using a transgastric approach, and histology revealed a primary hepatic lymphoma of a diffuse large B-cell lymphoma type.ConclusionsPrimary hepatic lymphomas are quite rare, and diagnosis is often difficult without performing a biopsy. Endoscopic ultrasound-guided liver biopsy is a useful diagnostic modality even in such cases.
Highlights
Because of the rarity of primary hepatic lymphomas, diagnosis of this disease entity may often be difficult, and performing a liver biopsy is the only way to establish a definitive diagnosis
Primary hepatic lymphomas are quite rare, and diagnosis is often difficult without performing a biopsy
Typical abnormalities revealed by laboratory test results associated with primary hepatic lymphoma (PHL) include anemia, neutropenia, hypercalcemia, and variably elevated serum lactate dehydrogenase (LDH) and bilirubin levels, as well as elevated alkaline phosphatase (ALP) and aminotransferase activities
Summary
Primary hepatic lymphomas are quite rare, and diagnosis is often difficult without performing a biopsy.
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