CASE 494: PRIMARY LIVER LYMPHOMA (PLL),Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Woman  62yo  with 5 months of history of epigastric  pain and  being  treated as gastritis  after gastroscopy. Ultrasound of liver  reported as inhomogeneous fatty liver.

Ultrasound liver  reviews  3 months later :  US 1  manny hypoechoic  focal lesions at peripheral area of liver with   size 2-3 cm  without  bending vascular sign.  (US 1 , US 2  CDI,  US 3   central  liver, US 4 liver elastography of this hypoechoic mass  is hard   41kPa, normal  liver is  18kPa) US 5 : big spleen .

MSCE with CE   detected hepato slenomegaly  with many  nodules  captured contrast in  arterial phases.

No  lymphadenomegalia  in abdomen.

MRI of  liver  with gado  Images with  many  hyperintense areas,  T1  captured  gado enhanced  peripheral   ( MRI 1, 2 ,3 ,4).

Blood tests =   HBV positive  EBV  IGG positive   Wako test negative   

Beta2 migroglobuline rised very high 8,341 UI/  IGG  rised to 2,188 UI   kappa IGG detected . 

Summary:  Based on  US imaging , CT with CE, MRI with CE and blood tests   diagnosis  is  PLL ( primary liver lymphoma ),   wait for  liver biopsy.

REFERENCE Case PLL.