Laparoscopic Liver Resection to Liver Malignant Lymphoma following DAA Treatment for Chronic Hepatitis—A Case Report—

Abstract

The patient was a 72-year-old woman who had undergone direct acting antivirals (DAA) therapy for chronic hepatitis due to HCV in the Department of Gastroenterology in our hospital. After the DAA therapy, the patient acquired sustained virological response (SVR). Ten months later, a follow-up CT scan revealed a 35-mm liver tumor in the right liver lobe. CT and MRI findings showed the tumor to be hepatocellular carcinoma or cholangiocellular carcinoma. Two months later, the patient was referred to our department for surgery when the tumor rapidly enlarged to 65 mm in diameter. The patient underwent laparoscopic liver S5 and S6 subsegmentectomy. Resected specimen showed that the tumor was yellowish white and 70 mm in diameter. The patient was discharged on the 7^th postoperative day. Pathology showed diffuse growth of atypical round lymphocytes, and the tumor cells were CD3 negative and CD 20 positive. Finally diffuse large B-cell lymphoma was diagnosed. This case serves as an important reminder to consider malignant lymphoma in the investigation of all possible causes of a liver tumor after DAA treatment.