Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2015; 3(2): 186-190
Published online Feb 16, 2015. doi: 10.12998/wjcc.v3.i2.186
Complete remission of primary hepatic lymphoma in a patient with human immunodeficiency virus
David Widjaja, Mohammad AlShelleh, Myrta Daniel, Yevgeniy Skaradinskiy
David Widjaja, Mohammad AlShelleh, Myrta Daniel, Yevgeniy Skaradinskiy, Division of Gastroenterology and Division of Oncology and Hematology, Department of Medicine, Bronx Lebanon Hospital Center, Bronx, NY 10457, United States
Author contributions: Widjaja D and Skaradinskiy Y designed the report; AlShelleh M collected the patient’s clinical data; Widjaja D, Daniel M and Skaradinskiy Y analyzed the data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: David Widjaja, MD, Division of Gastroenterology and Division of Oncology and Hematology, Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Ave, 10th floor, Bronx, NY 10457, United States. medicine.nyc@gmail.com
Telephone: +1-718-5185550 Fax: +1-718-5185111
Received: June 23, 2014
Peer-review started: June 23, 2014
First decision: October 14, 2014
Revised: October 28, 2014
Accepted: November 19, 2014
Article in press: November 19, 2014
Published online: February 16, 2015
Abstract

Diffuse large B cell primary hepatic lymphoma is a rare disease with limited available information regarding treatment strategy. Although the liver contains lymphoid tissue and is an important site for lymphocytes activation, primary hepatic lymphoma is rare. Host factors make the liver a poor environment for malignant lymphoma development. Its coexistence with human immunodeficiency virus (HIV) infection increases morbidity and mortality risks. Additionally, jaundice increases chances of developing adverse effects from chemotherapy. Here, we report a case of diffuse large B cell primary hepatic lymphoma in a 32-year-old HIV positive man. Due to elevated liver enzyme levels and jaundice, the patient was initially treated with an R-DHAP regimen, which was replaced with an R-CHOP regimen. Restaging images with a positron emission tomography scan after the latest chemotherapy cycle confirmed remission. This is the first report of complete remission of primary hepatic diffuse large B cell lymphoma in an HIV positive patient in the English literature.

Keywords: Primary hepatic lymphoma, Diffuse B cell lymphoma, Human immunodeficiency virus, R-DHAP, R-CHOP

Core tip: There are limited reports related to successful management of primary hepatic lymphoma in human immunodeficiency virus (HIV) patients. This case report is not only considered as the first report of complete remission of primary hepatic diffuse large B cell lymphoma in an HIV positive patient in the English literature, but also describes the use of R-DHAP as an induction regimen in the setting of significant impaired liver function and severe immunocompromised status. The use of R-DHAP as an induction regimen in management of primary hepatic lymphoma in HIV patients was never reported.