(18)F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in the diagnosis and follow-up of primary hepatic diffuse large B-cell Lymphoma: A clinical case report

RATIONALE: Primary hepatic lymphoma (PHL) is an extremely rare manifestation of extranodal non-Hodgkin lymphoma. There were few cases about PHL in recent years, while cases using positron emission tomography (PET) modalities for both diagnosis and follow-up were even rare. PATIENT CONCERNS: A 29-year-old man complaining of dull epigastric pain for 2 weeks. DIAGNOSIS: The features of liver biopsy and immunohistochemistry were consistent with diffuse large B cell lymphoma. Since there were no other foci of lymphoma on the (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/computed tomography (CT) images, the patient was further diagnosed with PHL. INTERVENTIONS: Since the lesions were mainly confined to the right lobe of liver, partial hepatectomy and radiofrequency ablation were performed. Subsequently, 6 cycles of rituximab, cyclophosphamide, adriamycin, vincristine, dexamethasone regimen were performed. OUTCOMES: The patient recovered well postoperatively and was discharged 1 week after surgery. Fortunately, the follow-up (18)F-FDG PET/CT scan 36 months later revealed no abnormal FDG uptake, indicating the absence of relapse. LESSONS: As the superiority in excluding other organ involvement, (18)F-FDG PET/CT should be considered as the preferable imaging modality for the diagnosis and follow-up of PHL. Besides chemotherapy, surgical resection should be considered initially. If radical R0 resection could not be done, partial hepatectomy with radiofrequency ablation may also offer an appropriate alternative treatment.