Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma Research Articles

Primary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue lymphoma treated by laparoscopic partial hepatectomy: a case report

BackgroundPrimary hepatic extranodal marginal zone B-cell mucosa-associated lymphoid tissue (MALT) lymphoma is very rare, so it is difficult to diagnose preoperatively. And there is no established treatment for hepatic MALT lymphoma. We report herein a case of primary hepatic MALT lymphoma treated by laparoscopic partial hepatectomy, and discuss the usefulness of laparoscopic hepatectomy for a rare liver tumor.Case presentationThis patient was a woman in her 60s, who was diagnosed preoperatively as having synchronous liver metastasis from sigmoid colon cancer; therefore, laparoscopic partial hepatectomy was performed. She had a good course after the operation and was discharged on postoperative day 12. However, she was diagnosed pathologically as having primary hepatic MALT lymphoma. A bone marrow biopsy was also performed, and then she was finally diagnosed as having limited-stage primary hepatic MALT lymphoma. She received no postoperative treatment and showed no recurrence for 4 years postoperatively.ConclusionsWe experienced the good result of the patient with limited-stage primary MALT lymphoma treated by laparoscopic partial hepatectomy. Liver tumors are sometimes misdiagnosed by imaging examinations alone. Laparoscopic hepatectomy has been widespread recently as a minimally invasive procedure, and it may be useful for both diagnosis and treatment.

A Rare Case of Hepatic MALT Lymphoma with Coexistence of Hepatitis B Virus and Echinococcus Infection

Primary hepatic extranodal mucosa-associated lymphoid tissue (MALT) lymphoma is seen extremely rare compromising 0,016% among non-Hodgkin lymphomas. Association of chronic inflammatory conditions or infectious processes mostly hepatitis B virus (HBV) infection has been reported by scarce number of case presentations. Whereas MALT lymphoma accompanied by echinococcus granulosus infection was described only in one primary pulmonary lymphoma case. We herein present a primary hepatic MALT lymphoma case with both HBV carrier state and liver hydatid cyst history. A 86 years old male patient referred to our clinic with a sole liver mass and was diagnosed with primary hepatic MALT lymphoma by core biopsy. Positron emission tomography detected increased uptake in the liver lesion without any other uptake site. He was successfully treated with rituximab-chemotherapy, tenofovir and albendazole. By adding one more case to the literature we aimed to emphasize the probable etiologic causative role of echinococcus infection in MALT lymphoma.

18F-FDG PET/CT and primary hepatic MALT: a case series.

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease and its glucidic metabolic behavior is not clear. We retrospectively analyzed five patients with histological diagnosis of primary hepatic MALT lymphoma who underwent twelve 18F-FDG PET/CT. All staging 18F-FDG PET/CT were positive showing 18F-FDG uptake (average SUVmax was 5.62±1.6) at the corresponding liver lesion. 18F-FDG PET/CT also was useful in evaluating the complete metabolic response after chemotherapy in three patients and radiotherapy in two. Besides, in one patient 18F-FDG PET/CT detected disease relapse during follow-up. Despite the low number of patients, our case series shows the 18F-FDG avidity of hepatic MALT and the possible role of 18F-FDG PET/CT in the management of these patients, both for staging, treatment response evaluation and restaging. Further studies are needed to confirm our results.

Primary Hepatic Mucosa-Associated Lymphoid Tissue Lymphoma: A Case Report

Mucosa-associated lymphoid tissue (MALT) lymphomas are an extranodal subset of marginal zone B-cell lymphomas and represent > 8% of all types of lymphomas (1). In 1983, Isaacson and Wright (2) initially described MALT lymphomas as a distinctive type of B-cell lymphoma arising in the gastrointestinal tract. MALT lymphomas can be found at mucosal sites such as the stomach, lung, and salivary gland or from sites, which share an embryologic origin with mucosa such as the thyroid that normally lacks organized lymphoid tissue (3). Primary hepatic MALT lymphoma is an extremely rare lesion, with only 45 cases reported in the English literature (4, 5). Because of its rarity, the radiologic findings in patients with this lesion are seldom described, to our best knowledge. Herein, we reported a patient with pathologically proven primary MALT lymphoma who underwent ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography with CT (FDG PET/CT).

Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review.

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. We herein describe the findings in a 74-year-old man with elevated liver enzyme levels. Dynamic computed tomography showed focal biliary dilation and atrophy in the posterior segment, while dynamic magnetic resonance images revealed a small, highly enhanced small mass located at the root of posterior branch of the biliary ducts. As the mass was not detected on abdominal ultrasonography, a biopsy could not be performed. Cholangiocellular carcinoma was suspected, and surgery was performed. However, the surgically resected hepatic tumor was a nodule of aggregated lymphocytes that formed a lymphoepithelial lesion. Immunohistochemical analysis revealed that the lymphoma cells were positive for CD20 and CD79a, but negative for CD3. No other lymphoid lesions were found during additional postoperative examinations. Therefore, the patient was diagnosed with primary hepatic MALT lymphoma. He was also diagnosed with Helicobacter pylori infection, and thus, pylorus eradication was performed. At the time of this report, the patient was free of disease for 2 years without any additional treatment. The present case contributed to the diagnosis and management of this rare disease, as previously published case reports described varying imaging features; it also suggested that preoperative diagnosis was often difficult without biopsy.

11. A case of extranodal marginal zone lyphoma of mucosa-associated lymphoid tissue (MALT) type and hepatocellular carcinoma

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease. MALT lymphoma is a type of low grade extranodal B-cell lymphoma which is commonly diagnosed in the stomach where there is a well-documented association with Helicobacter pylori infection. In reported cases of primary liver MALT, it is often an incidental finding during imaging or surgery for other disease and patients usually do not have symptoms specifically related to the lymphoma. The information available from reported cases of primary liver MALT lymphoma have included associated inflammatory diseases of the liver including hepatitis B or hepatitis C (either with or without cirrhosis) or primary biliary cirrhosis. This supports the role of chronic inflammation in the pathogenesis of the condition regardless of primary site. As primary hepatic MALT lymphoma is usually asymptomatic it is likely to be an under-reported diagnosis. Only one case of concurrent hepatocellular carcinoma with hepatic MALT lymphoma on a background of hepatitis B infection is reported in the literature. We present a case of a 62 year old patient who presented with non-cirrhotic hepatocellular carcinoma on a background of cleared chronic hepatitis B infection. The patient has positive hepatitis B core antibody with negative hepatitis B surface antigen. The right hepatectomy specimen showed moderately differentiated hepatocellular carcinoma as well as an incidental diagnosis of extranodal marginal zone lymphoma of MALT type and the gallbladder specimen also showed involvement. We present this additional case of concurrent hepatocellular carcinoma and hepatic MALT lymphoma to bring to attention this extremely rare entity.

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma.

Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare, and the etiology of disease is not fully understood. We present herein the case of a primary hepatic MALT lymphoma with Helicobacter pylori and hepatitis C virus infection. A 71-year-old male was admitted to our institution to undergo a precise evaluation of a hepatic tumor incidentally detected during a computed tomography (CT) scan for chest examination. Dynamic CT showed faint enhancement during the arterial phase. The gadoxetate disodium-enhanced magnetic resonance imaging showed a hyper-intensity on the arterial phase and low intensity during the late and hepatocyte phases. Liver biopsy specimen showed small to intermediate size atypical lymphocytes with positive CD20 immunohistochemical staining. It was finally diagnosed as primary hepatic MALT lymphoma. FDG-PET/CT showed faintly increased uptake with a maximum standardized uptake value of 4.6, and did not show other pathological uptake. We present the rare case of primary hepatic MALT lymphoma and discussed the etiology of this disease.

Primary Hepatic Marginal Zone B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue Type in a Liver Transplant Patient With Hepatitis B Cirrhosis

We describe the clinical, histological, and immunohistochemical features of primary hepatic low grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) in a liver transplant recipient with hepatitis B cirrhosis. MALT lymphomas arise in organs normally devoid of lymphoid tissue, which accumulates as a consequence of chronic antigenic stimulation associated with chronic infection or autoimmune disease. Primary hepatic MALT lymphoma is extremely rare; 13 cases have been reported worldwide to date. Our patient is the first case of primary hepatic MALT lymphoma associated with hepatitis B cirrhosis who was treated with orthotopic liver transplantation.