Nasim SALIMIAGHDAM, Ummi KHAN, Ruchit SHAH
Background: High-grade B-cell lymphomas involving the liver are rare and often present with vague, nonspecific symptoms. Clinically, these lymphomas can easily be mistaken for more common hepatic or infectious diseases, which, unfortunately, tends to delay both diagnosis and treatment.
Case Presentation: In this instance, a 66-year-old male with a prior history of Lyme disease and numerous tick bites presented with right upper quadrant discomfort and deranged liver enzymes. Imaging demonstrated hepatomegaly and multiple hepatic lesions, along with a progressive pattern of cholestatic liver injury. Extensive serologic, infectious, and autoimmune workups yielded no significant findings. Ultimately, a liver biopsy identified a CD10-positive high-grade B-cell lymphoma, most likely representing either diffuse large B-cell lymphoma (DLBCL, germinal center B-cell type) or a Burkitt variant. The patient received dexamethasone and was subsequently scheduled to begin R-EPOCH chemotherapy following PET staging.
Conclusion: This case underscores the importance of a multidisciplinary approach in evaluating unexplained liver disease. Clinicians should maintain a high index of suspicion for high-grade hepatic lymphomas in patients with rapid hepatic deterioration and B symptoms, especially if serologic testing is unrevealing. Prompt recognition and diagnosis are critical to improving patient outcomes in these rare but aggressive malignancies.
Keywords: B-cell lymphoma, high-grade lymphoma, liver masses, hepatomegaly, CD10+, DLBCL, RUQ pain, liver biopsy, oncology, case report
https://doi.org/10.59854/dhrrh.2026.4.2.83
Cite this article
Salimiaghdam N., Khan U., Shah R., Whispers from the Liver: A Hidden Case of CD10+ High-Grade B-cell Lymphoma. DHRRH, 2026, 6(2), https://doi.org/10.59854/dhrrh.2026.4.2.83
