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.