Abstract
Case Presentation A 71-year-old lady, with a background of Rheumatoid Arthritis on methotrexate presented with fever and weight loss. Imaging revealed a liver abscess with small volume lymphadenopathy present above and below the diaphragm. She was managed with IV antibiotics and cessation of methotrexate. Interestingly the patient improved clinically however a follow-up scan 3 months later demonstrated an increase in the size of the liver lesion to 3.5 X 2.5cm as well as multiple enlarged nodes in the porta hepatis and peripancreatic areas. The concern now was for an intrahepatic cholangiocarcinoma but histology was in keeping with Diffuse Large B-Cell Lymphoma. This lesion was reviewed by numerous pathologists. Image 1 shows the core biopsy with an infiltrate of CD20+ B cells with a Ki67 of 60-70%. EBER ish was negative within the biopsy.
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