Section snippets

Description

A 74-year-old male was admitted to our hospital with subtle jaundice and weight loss. His medical history included ulcerative colitis, well-controlled with mesalazine, and HCV infection successfully treated with direct-acting antivirals 2 years prior. Last liver stiffness measurement was 4.4 kPa. Laboratory tests showed a normal hemogram, moderate elevation of aminotransferases (aspartate aminotransferase 144 U/L, alanine aminotransferase 146 U/L; normal range [N] <40 U/L), significant

What is your diagnosis?

- Hilar hepatocellular carcinoma- Bismuth type IV Klatskin’s cholangiocarcinoma- B-cell lymphoma- IgG4-related disease

Diagnosis and outcome

The core needle biopsy showed a lymphoid infiltrate within fibrotic tissue with a vaguely nodular growth pattern (Fig. 2 upper panel), consisting of small, mature-looking lymphocytes with scattered large blasts (Fig. 2 insert on upper panel). The lymphoid population was diffusely positive for CD20 and BCL2, with variable expression of BCL6, and negativity for CD10. CD3 was positive in accompanying T cells, while the Ki67 index was low (10% of cells). Molecular analysis revealed a clonal

Indolent non-Hodgkin’s lymphoma – FL

Indolent B-cell lymphoma refers to a type of slow-growing NHL characterized by a long clinical course. Indolent lymphomas represent 35-45% of all NHLs, with FL being the second most common lymphoid malignancy in Western countries.¹ Ninety percent of patients with FL overexpress BCL2 due to the chromosomal translocation t(14;18), which confers anti-apoptotic properties to B cells. The overall risk of developing NHL is higher and occurs at a younger age in patients with HCV infection,

Financial support

The Authors received no financial support for this article.

Conflict of interest

The authors declare that they have no competing interest.Please refer to the accompanying ICMJE disclosure forms for further details.

Authors’ contribution

SB: conceived and wrote the manuscript; MP: provided histological images and their description; FPR, FP and SZ: provided clinical data; FPR: conceived and reviewed the manuscript. Data are available on request only due to ethical reasons.

中文翻译：

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从阴影到光明：肝肿块的不寻常病例

 部分片段

 描述

一名 74 岁的男性因轻微的黄疸和体重减轻入住我们医院。他的病史包括溃疡性结肠炎，美沙拉嗪控制良好，以及 2 年前用直接抗病毒药物成功治疗 HCV 感染。最后一次肝脏硬度测量为 4.4 kPa。实验室检查显示血象正常，转氨酶中度升高（天冬氨酸转氨酶 144 U/L，丙氨酸转氨酶 146 U/L;正常范围 [N] <40 U/L），显著

 您的诊断结果是什么？

- 肺门肝细胞癌 - 铋 IV 型 Klatskin 胆管癌 - B 细胞淋巴瘤 - IgG4 相关疾病

 诊断和结局

空芯针活检显示纤维化组织内的淋巴浸润，具有模糊的结节状生长模式（图 2 上图），由看起来成熟的小淋巴细胞和分散的大原始细胞组成（图 2 上图插入）。CD20 和 BCL2 淋巴细胞群呈弥漫性阳性，BCL6 表达不同，CD10 呈阴性。伴随 T 细胞的 CD3 阳性，而 Ki67 指数较低 （10% 的细胞）。分子分析揭示了克隆

惰性非霍奇金淋巴瘤 – FL

惰性 B 细胞淋巴瘤是指一种生长缓慢的 NHL，其特征是临床病程长。惰性淋巴瘤占所有 NHL 的 35-45%，FL 是西方国家第二常见的淋巴恶性肿瘤。¹ 90% 的 FL 患者由于染色体易位 t（14;18），它赋予 B 细胞抗凋亡特性。HCV 感染患者患 NHL 的总体风险更高，且发生年龄较小，

 财务支持

作者没有收到本文的财政支持。

 利益冲突

作者声明他们没有竞争利益。有关更多详细信息，请参阅随附的 ICMJE 披露表。

 作者贡献

SB：构思并撰写手稿;MP：提供组织学图像及其描述;FPR、FP 和 SZ：提供的临床数据;FPR：构思并审查手稿。出于道德原因，仅可应要求提供数据。