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Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C
Splenic marginal zone lymphoma (SMZL) accounts for only 1-2.7% of all lymphomas. Almost all patients have bone marrow (BM) involvement but only one-third has liver involvement. The higher prevalence of hepatitis C virus (HCV) infection in these patients has led to the hypothesis of viral involvement...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579832/ https://www.ncbi.nlm.nih.gov/pubmed/34786250 http://dx.doi.org/10.7759/cureus.18667 |
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author | Silva, Leonor Alpoim, Mafalda Ribeiro, Ana Caiano Gil, Pedro Lopes Caçola, Rute |
author_facet | Silva, Leonor Alpoim, Mafalda Ribeiro, Ana Caiano Gil, Pedro Lopes Caçola, Rute |
author_sort | Silva, Leonor |
collection | PubMed |
description | Splenic marginal zone lymphoma (SMZL) accounts for only 1-2.7% of all lymphomas. Almost all patients have bone marrow (BM) involvement but only one-third has liver involvement. The higher prevalence of hepatitis C virus (HCV) infection in these patients has led to the hypothesis of viral involvement in lymphomagenesis. In this report, we present a case of a 48-year-old woman, with cured hepatitis C, presenting with fever, weight loss, nausea, abdominal pain, and jaundice. She had leucocytosis with lymphocytosis, a progressively worsening cytocholestasis, and hepatosplenomegaly. Liver biopsy, immunophenotyping, and BM biopsy were performed, resulting in the diagnosis of SMZL. The patient started chemotherapy (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone) with an initial good response, but later progression to high-grade lymphoma and was recommended to undergo salvage chemotherapy followed by auto-transplant. Despite the unusual liver involvement, we should consider hepatic infiltration by lymphomas, such as SMZL, especially in patients with a history of HCV infection. |
format | Online Article Text |
id | pubmed-8579832 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-85798322021-11-15 Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C Silva, Leonor Alpoim, Mafalda Ribeiro, Ana Caiano Gil, Pedro Lopes Caçola, Rute Cureus Internal Medicine Splenic marginal zone lymphoma (SMZL) accounts for only 1-2.7% of all lymphomas. Almost all patients have bone marrow (BM) involvement but only one-third has liver involvement. The higher prevalence of hepatitis C virus (HCV) infection in these patients has led to the hypothesis of viral involvement in lymphomagenesis. In this report, we present a case of a 48-year-old woman, with cured hepatitis C, presenting with fever, weight loss, nausea, abdominal pain, and jaundice. She had leucocytosis with lymphocytosis, a progressively worsening cytocholestasis, and hepatosplenomegaly. Liver biopsy, immunophenotyping, and BM biopsy were performed, resulting in the diagnosis of SMZL. The patient started chemotherapy (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisolone) with an initial good response, but later progression to high-grade lymphoma and was recommended to undergo salvage chemotherapy followed by auto-transplant. Despite the unusual liver involvement, we should consider hepatic infiltration by lymphomas, such as SMZL, especially in patients with a history of HCV infection. Cureus 2021-10-11 /pmc/articles/PMC8579832/ /pubmed/34786250 http://dx.doi.org/10.7759/cureus.18667 Text en Copyright © 2021, Silva et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Silva, Leonor Alpoim, Mafalda Ribeiro, Ana Caiano Gil, Pedro Lopes Caçola, Rute Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title | Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title_full | Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title_fullStr | Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title_full_unstemmed | Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title_short | Hepatic Infiltration by Splenic Marginal Zone Lymphoma in a Patient With Cured Hepatitis C |
title_sort | hepatic infiltration by splenic marginal zone lymphoma in a patient with cured hepatitis c |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8579832/ https://www.ncbi.nlm.nih.gov/pubmed/34786250 http://dx.doi.org/10.7759/cureus.18667 |
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