Primary non-Hodgkin's lymphomas of the liver with nodular and diffuse infiltration patterns have different prognoses

Background: Primary liver non-Hodgkin's lymphomas have peculiar clinical an d biological patterns. This study correlates these patterns with pathology and outcome. Patients and methods: Clinical records and histology of patients with prima ry liver non-Hodgkin's lymphoma, treated at our institution over a 20-year period, were reviewed. Lymphoproliferations occurring after liver transplan tation were excluded. Survival analyses were performed with patients from t he other published series (62 patients). Results: Our series included eight patients. Three patients had a nodular l iver infiltration, corresponding to a large B-cell lymphoma. Five patients had a diffuse liver infiltration, of whom three had a T-cell lymphoma with predominant sinusoid infiltration, and two had a large B-cell lymphoma. Pat ients with diffuse liver infiltration presented with hepatomegaly, and two of these also had acute liver failure. Diffuse infiltration had a worse pro gnosis than nodular infiltration (P = 0.0033). Among these latter patients, those treated with an anthracyclin-based chemotherapy had a better outcome (P < 0.0001). Conclusions: Patients with primary liver lymphomas can be classified in two groups, depending on the type of infiltration. Those with nodular infiltra tion may benefit from anthracyclin-based chemotherapy. Diffuse infiltration has a bad prognosis, and should be suspected in patients presenting with a ltered liver functions and hepatomegaly.