Primary hepatic malignant lymphoma: Its occurrence in a patient with chronic active hepatitis, cirrhosis, and hepatocellular carcinoma associated with hepatitis B viral infection

A patient with hepatitis B induced chronic active hepatitis and cirrhosis had hepatocellular carcinoma and poorly differentiated lymphocytic malignant lymphoma localized in the liver. Whereas a close relationship between hepatitis B viral infection, chronic active hepatitis, macronodular cirrhosis, and hepatocellular carcinoma is now recognized, no such association has been reported with primary hepatic malignant lymphoma, which is a distinctly rare entity. In a large autopsy population that we reviewed, systemic malignant lymphoma rarely occurred in association with cirrhosis. Such an association has been noted in other studies, however. We speculate that if an association exists between malignant lymphoma and cirrhosis it might have an immunologic basis such as seen in certain autoimmune diseases.