Nodular lymphoid lesion of the liver with simultaneous focal nodular hyperplasia and hemangioma: discrimination from primary hepatic MALT-type non-Hodgkin's lymphoma

Virchows Arch. 2006 Feb;448(2):223-7. doi: 10.1007/s00428-005-0126-9. Epub 2005 Dec 6.

Abstract

Nodular lymphoid lesion (NLL) of the liver is a rare but unique entity and has also been termed reactive lymphoid hyperplasia of the liver. We describe the histological, immunohistochemical and molecular biologic findings of a case with NLL and two other tumors of the liver. The nodular lymphoid mass found in the liver was composed of heterogeneous small lymphocytes forming reactive follicles. Plasma cells, few immunoblasts, centroblasts, few macrophages, epithelioid cells, and giant cells were seen. The lymphoid infiltrate displaced the adjacent hepatic parenchyma. By immunohistochemistry and molecular studies, the lymphocytes were found to be polyclonal. The diagnosis of NLL was made. In addition to NLL, focal nodular hyperplasia and hemangioma were detected. The discrimination of NLL from primary hepatic malignant non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue-type may pose diagnostic difficulties and may require the use of immunohistochemical and molecular techniques. The simultaneous occurrence of NLL with focal nodular hyperplasia and hemangioma in the liver has not been described before.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antigens, CD20 / analysis
  • B-Lymphocytes / chemistry
  • B-Lymphocytes / pathology
  • CD3 Complex / analysis
  • Clone Cells / chemistry
  • Clone Cells / pathology
  • Diagnosis, Differential
  • Female
  • Focal Nodular Hyperplasia / metabolism
  • Focal Nodular Hyperplasia / pathology*
  • Focal Nodular Hyperplasia / surgery
  • Hemangioma / metabolism
  • Hemangioma / pathology*
  • Hemangioma / surgery
  • Humans
  • Immunohistochemistry
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / surgery
  • Lymphocytes / chemistry
  • Lymphocytes / pathology
  • Lymphoma, B-Cell, Marginal Zone / metabolism
  • Lymphoma, B-Cell, Marginal Zone / pathology
  • T-Lymphocytes / chemistry
  • T-Lymphocytes / pathology

Substances

  • Antigens, CD20
  • CD3 Complex