Non-Hodgkin lymphoma presenting with obstructive jaundice. Br J Surg 2003 Jul;90(7):845-9
Date
07/11/2003Pubmed ID
12854111DOI
10.1002/bjs.4119Scopus ID
2-s2.0-0037661012 (requires institutional sign-in at Scopus site) 44 CitationsAbstract
BACKGROUND: Obstructive jaundice is a rare presenting feature of non-Hodgkin lymphoma (NHL). Lymphomatous masses in the peripancreatic and hepatic hilar regions are potentially difficult to diagnose.
METHODS: A retrospective analysis was undertaken of patients presenting with obstructive jaundice secondary to NHL at a tertiary care hepatobiliary unit.
RESULTS: Over a 7-year period, six adults and three children with NHL were managed. The site of the lymphomatous mass was at the hepatic hilum in six patients and the peripancreatic area in three. Diagnostic procedures included a laparotomy and biopsy in four patients, hepatic trisectionectomy in two, percutaneous biopsy in two and lymph node biopsy in one patient. Percutaneous biopsy confirmed the diagnosis in both the patients in whom it was attempted. One patient died following liver resection. Chemotherapy was the mainstay of treatment and achieved complete remission in four patients, partial remission in three and no response in one patient. Two patients subsequently required operation for a benign biliary stricture after achieving complete remission.
CONCLUSION: NHL must be considered in the differential diagnosis of obstructive jaundice in adults and children. Attempts must be made to diagnose the condition using non-operative techniques. Chemotherapy is the mainstay of treatment. Late benign strictures of the bile duct requiring operation may develop.
Author List
Ravindra KV, Stringer MD, Prasad KR, Kinsey SE, Lodge JPAuthor
Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Biopsy, Needle
Child
Child, Preschool
Female
Hepatectomy
Humans
Jaundice, Obstructive
Liver Neoplasms
Lymphoma, B-Cell
Male
Middle Aged
Postoperative Care
Recurrence
Retrospective Studies
Treatment Outcome
