A Primary Hepatic Lymphoma in a Patient with Crohn's Disease Receiving Thiopurine and Anti-TNF Therapy: A Case Report

Abstract

Primary hepatic lymphoma is a rare variant of non-Hodgkin's lymphoma with an incidence of 0.016% of all non-Hodgkin lymphomas. The most common histologic subtype is large diffuse B-cell lymphoma. Pathogenesis is not clearly established and undergoing immunosuppressive therapy has been proposed as a risk factor for primary hepatic lymphoma. We report an intriguing case study, featuring a 23-year-old male patient with Crohn's Disease who had been receiving a combination therapy of thiopurine and anti-TNF for 6 years and was diagnosed with primary hepatic diffuse large B-cell lymphoma.

Plain Language Summary

Primary hepatic lymphoma is a rare type of cancer that mostly affects the liver and accounts for less than 1% of all lymphoma cases. The exact cause of primary hepatic lymphoma is unknown, but some evidence suggests that immunosuppressive therapy may increase the risk of developing this condition. We present a 23-year-old male patient who has a six-year history of Crohn's Disease, which is a long-lasting condition that causes inflammation. To manage his symptoms, he was taking two types of medications that weaken the immune system (thiopurine and anti-TNF medications). While being treated for Crohn's disease, he was also diagnosed with a rare type of primary hepatic lymphoma. This case raises intriguing questions about the relationship between immunosuppressive therapy and the development of primary hepatic lymphoma. It emphasizes the need for further research to better understand the underlying mechanisms and identify potential risk factors.

Tweetable abstract

A rare discovery. We present a compelling case of a 23-year-old male with Crohn's Disease, on immunosuppressive therapy, diagnosed with primary hepatic diffuse large B-cell lymphoma. #RareDisease #LymphomaAwareness.

Keywords:

• anti-TNF therapy
• Crohn's disease
• diffuse large -B cell lymphoma
• primary hepatic lymphoma
• thiopurine

Author contributions

S Merhaben: drafting the manuscript. S Ayadi, M Tangour, N Boujelbene, R Ghariani: critical revision of the manuscript for important intellectual content. L Mouelhi, F Merhaben: final approval of the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.