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Case Reports in Medicine
Volume 2013 (2013), Article ID 259642, 5 pages
http://dx.doi.org/10.1155/2013/259642
Case Report

Obstructive Jaundice as an Initial Manifestation of Non-Hodgkin Lymphoma: Treatment Dilemma and High Mortality

1Department of Internal Medicine, East Tennessee State University, Quillen College of Medicine, P.O. Box 70622, Johnson City, TN 37614, USA
2Department of Gastroenterology, East Tennessee State University, Quillen College of Medicine, Johnson City, TN 37614, USA
3Department of Oncology, VA Medical Center, Quillen College of Medicine, Mountain Home, TN 37684, USA

Received 14 April 2013; Accepted 15 May 2013

Academic Editor: Gianfranco D. Alpini

Copyright © 2013 Dhara Chaudhari et al. 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.

Abstract

Introduction. Non Hodgkin lymphoma (NHL) presenting with obstructive jaundice is a rare occurrence. Because of rarity of combination, it is seldom considered in differential diagnosis of patients presenting with obstructive jaundice. It is considered treatable due to the chemosensitive nature of the disease and the recent advances in chemotherapy. Case Series. We present a case series of 2 patients with NHL presenting with obstructive jaundice as an initial manifestation. Both patients presented with obstructive jaundice and were diagnosed by CT guided liver biopsy. One patient died of sepsis and multiorgan failure before initiating chemotherapy and the second patient did not choose to undergo chemotherapy. Conclusion. Biliary obstruction is a sign of poor prognosis. The diagnosis of NHL needs to be considered in patients presenting with biliary obstruction. It can be associated with high mortality and poses treatment dilemma.