Primary non-Hodgkin's lymphoma of liver

A 65-year-old male was presented his primary care physician with a two-month history of constipation, upper right abdominal pain and occasional right groin pain. His past medical history included hypertension and hepatitis B from which he had recovered (HBsAg negative). The biochemical analyses revealed alanine transaminase 35 U/L, aspartate transaminase 38 U/L and bilirubin level 26 mmol/L with normal blood count. The result of quantitative HBV DNA revealed an undetectable viral load which is generally lower than 300 copies/mL. Magnetic resonance imaging (MRI) scan of the abdomen showed a mass in the right lobe of the liver with a diameter of 10 cm, located on the right hemiliver (Figure 1A). The tumors markers CA19-9 was 57.3 IU/ mL (normal range <27 IU/mL), carcinoma antigen 15-3 was 29.6 IU/mL (normal range <5 IU/mL), and CA125 was 72.4 IU/mL (normal range <35 IU/mL). Alphafetoprotein and carcinoembryonic antigen were within normal range. Liver biopsy confirmed non-Hodgkin’s lymphoma, staining positive for CD20 lymphocytes.