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Case Reports in Gastrointestinal Medicine
Volume 2014, Article ID 925307, 6 pages
Case Report

Primary Hepatic Lymphoma Is Difficult to Discriminate from a Liver Abscess

1Department of Gastroenterology, Kawasaki Hospital, Kobe, Hyogo 652-0042, Japan
2Department of Laboratory Medicine, Kawasaki Hospital, Kobe, Hyogo 652-0042, Japan

Received 8 December 2013; Accepted 20 January 2014; Published 16 March 2014

Academic Editors: H. Akiho, I. C. Lawrance, I. M. Leitman, A. J. Lembo, and I. Siddique

Copyright © 2014 Nobuhiro Takeuchi and Kazuyoshi Naba. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


An 82-year-old woman presented with a high-grade fever of 40°C and was admitted to our institution for intensive examination and treatment. Noncontrast abdominal computed tomography (CT) revealed low-density masses at segments 5 and 8, suggestive of a liver abscess. On further examination, a contrast-enhanced abdominal CT showed a  mm mass with an enhanced margin at segment 8 in the arterial phase; the contrast agents were washed out in the venous phase. In addition, a  mm mass with a density lower than that of liver parenchyma was observed at segment 8 in the portal phase. On the basis of these findings, either a liver abscess or hepatocellular carcinoma was suspected. To confirm the diagnosis, a fine needle biopsy was scheduled. Histopathological analysis of the biopsied specimens confirmed the diagnosis of diffuse large B-cell lymphoma. Chemotherapy was not indicated owing to the patient’s age and poor performance status; thus, best supportive care was planned. On day 22 after admission, the patient died of pneumonia. We experienced a case of PHL that was difficult to discriminate from a liver abscess. Imaging alone is insufficient to diagnose PHL; therefore, fine needle biopsy is recommended for a definitive diagnosis.