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World J Gastroenterol. Sep 21, 2010; 16(35): 4491-4493
Published online Sep 21, 2010. doi: 10.3748/wjg.v16.i35.4491
Published online Sep 21, 2010. doi: 10.3748/wjg.v16.i35.4491
Febrile cholestatic disease as an initial presentation of nodular lymphocyte-predominant Hodgkin lymphoma
Anna Mrzljak, Slavko Gasparov, Ika Kardum-Skelin, Vesna Colic-Cvrlje, Slobodanka Ostojic-Kolonic, University of Zagreb, School of Medicine, Salata 3, 10000 Zagreb, Croatia
Anna Mrzljak, Vesna Colic-Cvrlje, Department of Gastroenterology, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia
Slavko Gasparov, Department of Pathology and Cytology, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia
Ika Kardum-Skelin, Laboratory for Cytology and Hematology, Department of Medicine, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia
Slobodanka Ostojic Kolonic, Department of Hematology, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia
Author contributions: Mrzljak A, Ostojic-Kolonic S and Gasparov S wrote the paper and followed up the patient; Kardum-Skelin I and Colić-Cvrlje V performed diagnostics and followed up the patient.
Correspondence to: Anna Mrzljak, MD, Department of Gastroenterology, University Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia. anna.mrzljak@gmail.com
Telephone: +385-1-2431390 Fax: +385-1-2431393
Received: April 8, 2010
Revised: May 24, 2010
Accepted: May 31, 2010
Published online: September 21, 2010
Revised: May 24, 2010
Accepted: May 31, 2010
Published online: September 21, 2010
Abstract
Febrile cholestatic liver disease is an extremely unusual presentation of Hodgkin lymphoma (HL). The liver biopsy of a 40-year-old man with febrile episodes and cholestatic laboratory pattern disclosed an uncommon subtype of HL, a nodular lymphocyte-predominant HL (NLPHL). Liver involvement in the early stage of the usually indolent NLPHL’s clinical course suggests an aggressiveness and unfavorable outcome. Emphasizing a liver biopsy early in the diagnostic algorithm enables accurate diagnosis and appropriate treatment. Although rare, HL should be considered in the differential diagnosis of cholestasis.