Journal of Gastrointestinal & Digestive System
Open Access

Case Report

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma Masquerading as Autoimmune Hepatitis with Clinical Features of Hemophagocytic Lymphohistiocytosis

Minesh Mehta^1*, Jiang Wang², Ross McHenry¹ and Stephen Zucker¹

¹Division of Digestive Diseases and University of Cincinnati, Cincinnati OH 45267-0595, USA

²Department of Pathology, University of Cincinnati, Cincinnati OH 45267-0595, USA

*Corresponding Author:

Minesh Mehta
Department of Internal Medicine
231 Albert Sabin Way, Cincinnati
OH 45267, USA
Tel: 706-248-9331
E-mail: mehtame@ucmail.uc.edu

Received date: March 14, 2015; Accepted date: April 16, 2015;Published date: April 28, 2015

Citation: Mehta M, Wang J, McHenry R, Zucker S (2015) T-Cell/Histiocyte-Rich Large B-Cell Lymphoma Masquerading as Autoimmune Hepatitis with Clinical Features of Hemophagocytic Lymphohistiocytosis. J Gastrointest Dig Syst 5:283. doi:10.4172/2161-069X.1000283

Copyright: ©2015 Mehta M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

We report the case of a 20-year-old male who presented with acute hepatitis resembling autoimmune hepatitis, but subsequently found to be T-Cell Rich/Histiocyte Rich Large B-Cell Lymphoma. Our patient was mistakenly diagnosed with autoimmune hepatitis based on liver histology demonstrating a pronounced lobular and portal infiltrate comprised predominately of polyclonal T cells, in the setting of negative serologic testing. This conclusion was reinforced by a compelling biochemical response to standard immunosuppressive therapy. The correct diagnosis of T/HRBCL subsequently was established by bone marrow biopsy (and confirmed by lymph node biopsy) when the patient presented with clinical features of HLH. In conclusion, our case elucidates a unique clinical spectrum of T/HRBCL. This patient initially presented with acute hepatitis, before mistakenly being diagnosed with autoimmune hepatitis and finally exhibited clinical features of HLH, which led to the diagnosis of T/HRBCL. It is critical to consider lymphoma in the differential for acute hepatopathy and clinical features of HLH.

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