Biliary Necrosis in Liver Lymphoma

Authors

Daniel Yuxuan Ong Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
Yi-Wei Wu Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore

DOI:

Abstract

Hepatic lymphoma is a rare condition. Biliary complication such as biliary necrosis is a potential treatment complication. We present a case where a patient with hepatic lymphoma encountered biliary necrosis after combination therapy. A 77-year-old Chinese male with biopsy proven diffuse large B cell lymphoma was treated with chemotherapy and radiation therapy (RT). He received intensity-modulated radiation therapy (IMRT) of 30.6 Gy/18 fractions to prechemotherapy volume, and 39.6 Gy/18 fractions to the post chemotherapy residual tumor, using concomitant boost technique. He was later found to have possible biliary necrosis on computed tomography scan. This was later confirmed during an intra-operative cholangiogram done for a percutaneous transhepatic biliary drainage procedure. This case report demonstrates a rare case of biliary necrosis, possibly related to the natural history of tumor necrosis and treatment (combination therapy), in a patient with hepatic lymphoma.

Author Biographies

Daniel Yuxuan Ong, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore

Senior Resident

Department of Diagnostic Radiology

National Healthcare Group

Yi-Wei Wu, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore

The right hepatic lobe tumor (hepatic lymphoma) is noted with gas foci within the necrotic component. The right portal vein courses through the necrotic mass and appears attenuated (black arrow). Several dilated intrahepatic ducts are seen connected to the necrotic mass (white arrows). Image insets: Preceding positron emission tomography computed tomography (PET CT) images which demonstrates a fluorodeoxyglucose (FDG)-avid right hepatic lobe mass.

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Published

2025-01-09

Issue

Vol. 18 No. 11 (2024)

Section

Gastrointestinal Radiology

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