Survival from Primary Abdominal Lymphoma Presenting with a Mass and Obstructive Jaundice

Hugh J Freeman,Andrew M Seal

doi:10.1155/1996/956983

Abstract

A 68-year-old female presented with an enlarged and nontender palpable gallbladder and clinical features of obstructive jaundice. Subsequent laboratory investigations confirmed the presence of cholestasis associated with an obstructing mass in the region of the common hepatic duct. Pathological evaluation of the mass revealed a localized abdominal lymphoma. Treatment with chemotherapy and radiation resulted in complete clinical remission (for almost 14 years at the last evaluation). Primary abdominal lymphoma may involve the hilar region and present as a localized mass. Precise tissue diagnosis is essential to permit an aggressive management approach with the potential for significant clinical benefit.

Highlights

Extrahepatic biliary ductal obstruction with lymphoma is a rare cause of jaundice and an even rarer manifestation of lymphoma [1]
Primary lymphoma arising in the abdomen may remain localized in the hepatic hilar region leading to an abdominal mass and biliary ductal obstruction; this was recently described for the first time in the English literature in a patient from Hong Kong [2]
The patient described here presented with clinical and laboratory features of painless jaundice due to an extrahepatic biliary ductal obstruction, which was initially believed to be due to pancreatic carcinoma

Summary

BRIEF COMMUNICATION

Survival from primary abdominal lymphoma presenting with a mass and obstructive jaundice. Primary abdominal lymphoma may involve the hilar region and present as a localized mass. Primary lymphoma arising in the abdomen may remain localized in the hepatic hilar region leading to an abdominal mass and biliary ductal obstruction; this was recently described for the first time in the English literature in a patient from Hong Kong [2]. The clinical follow-up after biliary tract stenting, surgery and chemotherapy was limited to just over one year. The patient described here presented with clinical and laboratory features of painless jaundice due to an extrahepatic biliary ductal obstruction, which was initially believed to be due to pancreatic carcinoma.

Freeman and Seal

Obstructive jaundice and lymphoma

DISCUSSION

CONCLUSIONS