Journal of Digestive Cancer Research 2018; 6(1): 32-35
Published online June 30, 2018
© Korean Society of Gastrointestinal Cancer
Non-Hodgkin’s lymphoma is known to be a rare and unusual cause of biliary obstruction. We report a case of biliary obstruction that a 25-year-old male showed icteric sclera and yellow discoloration of his skin caused by metastasis of non-Hodgkin lymphoma. Initial imaging & endoscopic work-up led us to an impression of either cholangiocarcinoma or IgG4-related disease, yet the pathological results weren’t diagnostic. Through our thorough re-examination, we found a 5cm sized round, fixed, non-tender sternal mass, and additional imaging studies were suggestive of lymphoma, which was also consistent with the results of incisional chest wall biopsy. Biliary obstruction by lymphoma was successfully treated by endoscopic plastic stent insertion procedure and chemotherapy. Although it is widely accepted that lymphoma accounts for very few portion of malignant biliary obstruction, due to the fact that lymphoma and cholangiocarcinoma are often indistinguishable, careful diagnostic approach should be done.
KeywordsLymphoma Biliary obstruction Obstructive jaundice DLBCL Diffuse large B cell lymphoma
Journal of Digestive Cancer Research 2018; 6(1): 32-35
Published online June 30, 2018
Copyright © Korean Society of Gastrointestinal Cancer Research.
Jae Hyun Lim, Huapyong Kang, Jung Hyun Jo, Hee Seung Lee, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Moon Jae Chung
Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Non-Hodgkin’s lymphoma is known to be a rare and unusual cause of biliary obstruction. We report a case of biliary obstruction that a 25-year-old male showed icteric sclera and yellow discoloration of his skin caused by metastasis of non-Hodgkin lymphoma. Initial imaging & endoscopic work-up led us to an impression of either cholangiocarcinoma or IgG4-related disease, yet the pathological results weren’t diagnostic. Through our thorough re-examination, we found a 5cm sized round, fixed, non-tender sternal mass, and additional imaging studies were suggestive of lymphoma, which was also consistent with the results of incisional chest wall biopsy. Biliary obstruction by lymphoma was successfully treated by endoscopic plastic stent insertion procedure and chemotherapy. Although it is widely accepted that lymphoma accounts for very few portion of malignant biliary obstruction, due to the fact that lymphoma and cholangiocarcinoma are often indistinguishable, careful diagnostic approach should be done.
Keywords: Lymphoma, Biliary obstruction, Obstructive jaundice, DLBCL, Diffuse large B cell lymphoma