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Virtual case of the month
Primary hepatic follicular lymphoma 5 years post sustained virological response from hepatitis C viral infection
  1. Tomonari Shimagaki,
  2. Takashi Maeda,
  3. Nao Kinjo,
  4. Daisuke Imai,
  5. Huanlin Wang,
  6. Nao Ohama,
  7. Keitaro Edahiro,
  8. Makoto Edagawa,
  9. Tomoyoshi Takenaka,
  10. Takahiro Ohmine,
  11. Shohei Yamaguchi,
  12. Kozo Konishi,
  13. Shinichi Tsutsui,
  14. Hiroyuki Matsuda
  1. Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
  1. Correspondence to Dr Tomonari Shimagaki, Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan; tomo_s{at}surg2.med.kyushu-u.ac.jp

https://doi.org/10.1136/jclinpath-2020-206469

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    Clinical question

    A 72-year-old man who was treated with a combination of simeprevir with peginterferon and ribavirin for hepatitis C virus (HCV) infection (genotype 1b) 5 years ago and has been treated as sustained virological response, was found to have a 2.6 cm tumourous lesion in the medial segment of the liver. He underwent a left hepatic lobectomy with a diagnosis of suspected hepatocellular carcinoma. The patient remained stable in follow-up CT every 3 months for more than 14 months.

    Differential diagnoses

    1. Hepatocellular carcinoma.

    2. Mantle cell lymphoma.

    3. Mucosa-associated lymphoid tissue lymphoma.

    4. Primary diffuse large B-cell lymphoma.

    5. Primary hepatic follicular lymphoma.

    Discussion

    Primary hepatic lymphoma (PHL) is a rare disease, representing 0.4% of extranodal non-Hodgkin’s lymphoma.1 The most common histological type is reported to be diffuse large B-cell lymphoma. …

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    Footnotes

    • Handling editor Iskander Chaudhry.

    • Contributors TS, TM, NK, DI and HW were all involved in the operation and the treatment of the patient. TS and NO prepared the manuscript and the literature search. TM gave the final approval of the version to be published. All authors including KE, ME, TT, TO, SY, KK, ST and HM read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.