A case of intravascular lymphoma diagnosed in an explanted liver after liver transplantation

Transpl Int. 2015 Oct;28(10):1245-50. doi: 10.1111/tri.12611. Epub 2015 Jun 8.

Abstract

Intravascular lymphoma (IVL) is a rare form of B-cell lymphoma. We encountered a rare case of IVL diagnosed in an explanted liver. A 49-year-old man visited a clinic with high fever. Because of elevated liver function, he was diagnosed with acute liver failure. Deceased donor liver transplantation (LT) was performed 16 days after admission. The post-transplantation course was uneventful until IVL was reported in the explanted liver on postoperative day (POD) 21. Rituximab was administered on POD 27, and rituximab-cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone (R-CHOP) treatment administered on POD 38. The R-CHOP treatment was repeated for eight cycles, and the patient remains free of recurrence 1 year post-transplantation. Although systemic lymphoma is a contraindication to transplantation, our experience indicates that IVL can be successfully treated by the administration of prompt chemotherapy after LT for fulminant hepatitis.

Keywords: deceased donors; liver clinical, outcome.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Antigens, CD20 / analysis
  • Antigens, Neoplasm / analysis
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Blood Vessels / pathology*
  • Cyclophosphamide / administration & dosage
  • Doxorubicin / administration & dosage
  • Gallbladder / blood supply
  • Hemangioma / complications
  • Hepatic Encephalopathy / etiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidental Findings
  • Liver / blood supply*
  • Liver / pathology
  • Liver Failure / etiology*
  • Liver Failure / surgery
  • Liver Neoplasms / complications
  • Liver Transplantation*
  • Lymphoma, B-Cell / complications
  • Lymphoma, B-Cell / diagnosis*
  • Lymphoma, B-Cell / drug therapy
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasms, Multiple Primary / diagnosis*
  • Neoplasms, Multiple Primary / drug therapy
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / drug therapy
  • Prednisone / administration & dosage
  • Purpura, Thrombocytopenic, Idiopathic / complications
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Purpura, Thrombocytopenic, Idiopathic / surgery
  • Respiratory Tract Infections / complications
  • Rituximab / administration & dosage
  • Splenectomy
  • Transplants / pathology
  • Vincristine / administration & dosage

Substances

  • Antigens, CD20
  • Antigens, Neoplasm
  • Immunosuppressive Agents
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone

Supplementary concepts

  • CHOP protocol