Primary hepatic mucosa-associated lymphoid tissue lymphoma: Case report and literature review

Primary hepatic mucosa-associated lymphoid tissue lymphoma (MALToma) is a very rare disease and the diagnosis is often only made after histologic examination. To date, there is no consensus on its treatment modalities. In this paper, we report a case of primary hepatic MALToma and literature review of this rare disease. Our patient was a 72-year-old woman who presented with elevated alkaline phosphatase level. She was neither a hepatitis B nor C carrier. The alpha-fetoprotein level was normal. Ultrasound of the abdomen found two hypoechoic liver lesions. Triphasic contrast computed tomography of the liver showed two arterial enhancing lesions with portovenous and delayed washout at segment 2 (1.7 cm) and segment 4b (2.5 cm), respectively. Fluorodeoxyglucose-positron emission tomography showed two hypermetabolic foci in segments 2 and 4b of the liver, respectively, compatible with hepatocellular carcinoma. There was diffuse fluorodeoxyglucose uptake in the stomach. Oesophagogastroduodenoscopy (OGD) was performed, which showed diffuse gastritis only. Laparoscopic left hepatectomy was performed for the suspected hepatocellular carcinoma. Histological examination demonstrated the diagnosis of MALToma. Further bone marrow trephine did not show any bone marrow involvement by the lymphoma. The patient refused adjuvant chemotherapy.