Primary pancreatic lymphoma(PPL)is an extremely rare form of extranodal malignant lymphoma.The most common histological subtype of PPL is diffuse large B cell lymphoma(DLBCL).In rare cases,PPL can also present as foll...Primary pancreatic lymphoma(PPL)is an extremely rare form of extranodal malignant lymphoma.The most common histological subtype of PPL is diffuse large B cell lymphoma(DLBCL).In rare cases,PPL can also present as follicular lymphoma,small lymphocytic lymphoma,and T cell lymphoma either of non-Hodgkin’s lymphoma or of Hodgkin’s lymphoma.T-cell/histiocyterich large B-cell lymphoma(T/HRBCL)is an uncommon morphologic variant of DLBCL with aggressive clinical course,it is predominantly a nodal disease,but extranodal sites such as bone marrow,liver,and spleen can be involved.Pancreatic involvement of T/HRBCL was not presented before.Herein,we report a 48-year-old male who was hospitalized with complaints of jaundice,dark brown urine,pale stools,and nausea.The radiological evaluation revealed a pancreatic head mass and,following operative biopsy,the tumor was diagnosed as T/HRBCL.The patient achieved remission after six cycles of CHOP chemotherapy.Therefore,T/HRBCL can be treated similarly to the stage-matched DLBCL and both of them get equivalent outcomes after chemotherapy.展开更多
BACKGROUND While tuberculosis(TB)itself is a common disease,isolated TB of the liver is a rare entity.Tubercular involvement of the liver is more commonly a part of a disseminated disease of the hepatic parenchyma.In ...BACKGROUND While tuberculosis(TB)itself is a common disease,isolated TB of the liver is a rare entity.Tubercular involvement of the liver is more commonly a part of a disseminated disease of the hepatic parenchyma.In contrast,isolated hepatic TB spread through the portal vein from the gastrointestinal tract is seldom encountered in clinical practice,with only a few sporadic cases and short series available in the current literature.Vascular complications,such as portal vein thrombosis(PVT),have rarely been reported previously.CASE SUMMARY A 22-year-old man was hospitalized with complaints of a 3-mo history of fever and weight loss of approximately 10 kg.He had a 10-year hepatitis B virus(HBV)infection in his medical history.Contrast-enhanced computed tomography(CECT)confirmed hepatosplenomegaly,with hypodensity of the right lobe of the liver and 2.1 cm thrombosis of the right branch of the portal vein.A liver biopsy showed epithelioid granulomas with a background of caseating necrosis.ZiehlNelson staining showed acid-fast bacilli within the granulomas.The patient was diagnosed with isolated hepatic TB with PVT.Anti-TB therapy(ATT),including isoniazid,rifapentine,ethambutol,and pyrazinamide,was administered.Along with ATT,the patient was treated with entecavir as an antiviral medication against HBV and dabigatran as an anticoagulant.He remained asymptomatic,and follow-up sonography of the abdomen at 4 mo showed complete resolution of the PVT.CONCLUSION Upon diagnosis of hepatic TB associated with PVT and HBV coinfection,ATT and anticoagulants should be initiated to prevent subsequent portal hypertension.Antiviral therapy against HBV should also be administered to prevent severe hepatic injury.展开更多
文摘Primary pancreatic lymphoma(PPL)is an extremely rare form of extranodal malignant lymphoma.The most common histological subtype of PPL is diffuse large B cell lymphoma(DLBCL).In rare cases,PPL can also present as follicular lymphoma,small lymphocytic lymphoma,and T cell lymphoma either of non-Hodgkin’s lymphoma or of Hodgkin’s lymphoma.T-cell/histiocyterich large B-cell lymphoma(T/HRBCL)is an uncommon morphologic variant of DLBCL with aggressive clinical course,it is predominantly a nodal disease,but extranodal sites such as bone marrow,liver,and spleen can be involved.Pancreatic involvement of T/HRBCL was not presented before.Herein,we report a 48-year-old male who was hospitalized with complaints of jaundice,dark brown urine,pale stools,and nausea.The radiological evaluation revealed a pancreatic head mass and,following operative biopsy,the tumor was diagnosed as T/HRBCL.The patient achieved remission after six cycles of CHOP chemotherapy.Therefore,T/HRBCL can be treated similarly to the stage-matched DLBCL and both of them get equivalent outcomes after chemotherapy.
文摘BACKGROUND While tuberculosis(TB)itself is a common disease,isolated TB of the liver is a rare entity.Tubercular involvement of the liver is more commonly a part of a disseminated disease of the hepatic parenchyma.In contrast,isolated hepatic TB spread through the portal vein from the gastrointestinal tract is seldom encountered in clinical practice,with only a few sporadic cases and short series available in the current literature.Vascular complications,such as portal vein thrombosis(PVT),have rarely been reported previously.CASE SUMMARY A 22-year-old man was hospitalized with complaints of a 3-mo history of fever and weight loss of approximately 10 kg.He had a 10-year hepatitis B virus(HBV)infection in his medical history.Contrast-enhanced computed tomography(CECT)confirmed hepatosplenomegaly,with hypodensity of the right lobe of the liver and 2.1 cm thrombosis of the right branch of the portal vein.A liver biopsy showed epithelioid granulomas with a background of caseating necrosis.ZiehlNelson staining showed acid-fast bacilli within the granulomas.The patient was diagnosed with isolated hepatic TB with PVT.Anti-TB therapy(ATT),including isoniazid,rifapentine,ethambutol,and pyrazinamide,was administered.Along with ATT,the patient was treated with entecavir as an antiviral medication against HBV and dabigatran as an anticoagulant.He remained asymptomatic,and follow-up sonography of the abdomen at 4 mo showed complete resolution of the PVT.CONCLUSION Upon diagnosis of hepatic TB associated with PVT and HBV coinfection,ATT and anticoagulants should be initiated to prevent subsequent portal hypertension.Antiviral therapy against HBV should also be administered to prevent severe hepatic injury.
