Chemotherapy Versus Surgery in Primary B-Cell Lymphoma Masquerading as Klatskin Tumor-A Diagnostic and Therapeutic Dilemma

Primary lymphoma in the region of the liver bed mimicking hilar cholangiocarcinoma or Klatskin tumor is very rare. A patient presented with obstructive jaundice along with right upper quadrant pain, weight loss, and decreased appetite. Apart from altered liver function, her lactate dehydrogenase was significantly elevated, and imaging studies showed prominent lesion close to the liver bed with localized lymphadenopathy. The diagnosis ultimately reached at by biopsy and immunohistochemical staining was diffuse large B-cell lymphoma. Such cases are very infrequent, but demand awareness. The sooner the diagnosis can be reached by minimally invasive procedures, the earlier chemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone can be initiated and laparotomy can be avoided as chemotherapy is the mainstay of treatment, even in the presence of jaundice.