Primary Hepatic Diffuse Large B-cell Lymphoma Mimicking Acute Fulminant Hepatitis: A Case Report and Review of the Literature

Primary hepatic lymphoma (PHL) is a rare variant of non-Hodgkin’s lymphoma. Diffuse hepatic involvement is uncommon and therefore presentation as progressive hepatitis or acute fulminant hepatic failure is rare. Acute onset of signs and symptoms can mimic a variety of infectious and inflammatory disorders, thus delaying the diagnosis. A high index of suspicion and liver biopsy early in the course of liver dysfunction may establish the diagnosis and allow rapid initiation of chemotherapy to prevent a fatal outcome. In this report, we describe a rare case of fulminant primary hepatic diffuse large B-cell lymphoma in a 55-year-old woman who died 2 weeks after admission, before the initiation of chemotherapy. LEARNING POINTS: Primary hepatic lymphoma (PHL) is a rare yet serious disease which should be suspected in every case presenting as hepatitis with unclear aetiology. A liver biopsy should be performed as early as possible when PHL is suspected. Failure to detect PHL early can result in rapid deterioration and death within 2 weeks of presentation.