INCIDENCE AND PATTERN OF LIVER INVOLVEMENT IN HEMATOLOGICAL MALIGNANCIES

The incidence and pattern of liver involvement in 127 liver specimens (2 biopsy and 125 autopsy specimens) from cases of acute myelogenous l eukaemia (25), chronic myelogenous leukaemia (7), acute lymphatic leuk aemia (5), chronic lymphatic leukaemia (9), multiple myeloma (25), low -grade non-Hodgkin's lymphoma (25), high-grade non-Hodgkin's lymphoma (24) and myeloproliferative diseases (7) were investigated histologica lly and immunohistochemically. Liver infiltration was found frequently in chronic leukaemia and myeloproliferative diseases (80-100%), acute leukaemia (60-70%) and non-Hodgkin's lymphoma (50-60%), but was signi ficantly less common in multiple myeloma (32%) than in any of the othe r diagnostic groups. Hepatomegaly was found in over 50% of cases in al l the diagnostic groups, but was not always associated with infiltrati on. Diffuse, non-destructive infiltration was most common: in acute my elogenous leukaemia, both the portal triads and sinusoids were usually involved, in chronic myelogenous leukaemia, multiple myeloma and myel oproliferative diseases, infiltration was mainly sinusoidal; and in ly mphatic leukaemia and non-Hodgkin's lymphoma the portal triads were ma inly involved. Nodular infiltration was seen in multiple myeloma and n on-Hodgkin's lymphoma. The primary tumours and liver infiltrates gener ally exhibited the same immunophenotype, although reactivity with the antibody L26 (CD20) was only found in the primary lesion in many high- grade B-cell lymphomas. Thus, liver involvement is common in haematolo gical malignancies, but the incidence and pattern of infiltration vary amongst the different types.