[Successful treatment with combination of plasma exchange and chemotherapy for CD5-positive primary hepatosplenic diffuse large B-cell lymphoma complicated with acute liver injury].
Rinsho Ketsueki
; 55(8): 958-64, 2014 Aug.
Article
in Ja
| MEDLINE
| ID: mdl-25186486
ABSTRACT
Primary hepatosplenic CD5-positive diffuse large B cell lymphoma (CD5⺠DLBCL) has recently been characterized as showing hepatosplenomegaly without lymphadenopathy, a portal and intrasinusoidal pattern of infiltration in the liver, and bone marrow invasion by lymphoma cells, without intravascular involvement. A 45-year-old man presented with fever and malaise in June 2013. Computed tomography showed hepatosplenomegaly and multiple liver tumors without lymphadenopathy. An ultrasonography-guided needle biopsy of the liver mass revealed portal and intrasinusoidal infiltration of CD5âºCD20⺠lymphoma cells and large numbers of destroyed hepatocytes. These findings were diagnostic of primary hepatosplenic CD5⺠DLBCL. Upon admission, lymphoma cells also appeared in the peripheral blood and serum hepatocyte growth factor (HGF) was markedly elevated. A bone marrow biopsy revealed extensive invasion by lymphoma cells. Seven days after admission, his laboratory data showed elevated aminotransferase and serum creatinine levels. Therefore, dose-reduced CH(O)P, with rituximab (R-CHOP) therapy, plasma exchange, and continuous hemodiafiltration, was initiated. The patient achieved complete remission after 4 courses of R-CHOP therapy. HGF is useful for predicting acute liver damage. If the HGF level is high, remission induction therapy, with plasma exchange, is necessary at an early stage.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Plasma Exchange
/
Lymphoma, B-Cell
/
Antibodies, Monoclonal, Murine-Derived
/
Liver Diseases
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
Ja
Journal:
Rinsho Ketsueki
Year:
2014
Document type:
Article