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Simple Summary: This study focused on a 10-year-old dog presenting with weight loss, excessive drinking, and liver-related issues. The aim was to understand a rare type of lymphoma affecting the liver and spleen, known as hepatosplenic T-cell lymphoma. By examining tissue samples from the spleen, liver, and gallbladder, researchers identified abnormal cells indicating hepatosplenic T-cell lymphoma. Surgery and subsequent treatment with toceranib, a drug not commonly used for this lymphoma in dogs, led to a notable improvement in the dog's condition. This finding suggests toceranib could be an effective treatment option for hepatosplenic T-cell lymphoma in canines. The study's results highlight the potential of new treatments for rare diseases in pets, offering hope for improved care and outcomes in veterinary oncology. Toceranib phosphate (toceranib) is approved for canine mast cell tumor treatment. However, no long-term response to toceranib in canine HSTCL has been reported. Here, we describe a case of a 10-year-old castrated mixed-breed dog that presented with a 3-month history of weight loss, polydipsia, and polyuria. The clinicopathological and imaging abnormalities included icterus, biliary obstruction, and splenomegaly with multiple diffuse splenic hypoechoic nodules. On day 21, a cholecystectomy was performed to remove the obstruction, followed by a liver biopsy and splenectomy. Cytology of the spleen and liver showed many small lymphocytes with intracytoplasmic granules (sGLs). Splenic and hepatic infiltration of neoplastic CD3/granzyme B-positive small cells and lymphocytic cholecystitis with granzyme B-negative small cells were noted. T-cell receptor gene clonal rearrangements were observed in the liver tissues. The dog was diagnosed with a hepatosplenic T-cell lymphoma (HSTCL) of sGLs concurrent with lymphocytic cholecystitis. The icterus resolved after surgery, but there was progressive elevation of liver enzyme levels. Toceranib was administered from day 39, resulting in decreased liver enzyme levels, and the dog remained in good condition. The dog stayed in remission after toceranib administration and survived for 460 days. Toceranib should be considered an effective treatment option for canine HSTCL. [ABSTRACT FROM AUTHOR]

Toceranib phosphate (toceranib) is approved for canine mast cell tumor treatment. However, no long-term response to toceranib in canine HSTCL has been reported. Here, we describe a case of a 10-year-old castrated mixed-breed dog that presented with a 3-month history of weight loss, polydipsia, and polyuria. The clinicopathological and imaging abnormalities included icterus, biliary obstruction, and splenomegaly with multiple diffuse splenic hypoechoic nodules. On day 21, a cholecystectomy was performed to remove the obstruction, followed by a liver biopsy and splenectomy. Cytology of the spleen and liver showed many small lymphocytes with intracytoplasmic granules (sGLs). Splenic and hepatic infiltration of neoplastic CD3/granzyme B-positive small cells and lymphocytic cholecystitis with granzyme B-negative small cells were noted. T-cell receptor gene clonal rearrangements were observed in the liver tissues. The dog was diagnosed with a hepatosplenic T-cell lymphoma (HSTCL) of sGLs concurrent with lymphocytic cholecystitis. The icterus resolved after surgery, but there was progressive elevation of liver enzyme levels. Toceranib was administered from day 39, resulting in decreased liver enzyme levels, and the dog remained in good condition. The dog stayed in remission after toceranib administration and survived for 460 days. Toceranib should be considered an effective treatment option for canine HSTCL.

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Simple Summary: The study aimed to distinguish between two important causes of liver disease in cats: lymphocytic inflammation and lymphoma. Both conditions are characterized by infiltration of small lymphocytes, making an accurate diagnosis difficult. Since the neoplastic cells of a lymphoma are derived from a single clone, a monoclonal population indicates a neoplastic condition in contrast to a polyclonal inflammatory condition. Clonality testing is therefore commonly used to detect lymphoma. The goal of our study was to define specific visual patterns of lymphocytic infiltrates in liver biopsies of cats which are predictive of a lymphoma or inflammation. A retrospective study was performed on 44 cats' biopsies, and the lymphocytic infiltrates were characterized and correlated with clonality results. Four patterns of lymphocytic infiltrates were characterized: (1) tightly periportal, (2) periportal and centrilobular, (3) nodular, and (4) periportal with sinusoidal extension. Sensitivity and specificity of the lymphocytic patterns to diagnose lymphomas were analyzed against clonality results. Lymphocytic patterns 2, 3, and 4 accurately diagnosed hepatic lymphomas with a sensitivity and specificity of 82% and 77%, respectively. These four patterns of lymphocyte infiltrates provide useful diagnostic information and allow more accurate differentiation of a lymphoma from inflammation. Hepatic lymphoma is poorly characterized in cats and differentiating between inflammation and lymphomas is often difficult. The diagnosis of hepatic lymphoma in humans relies on recognition of specific patterns of lymphocytic infiltrates and clonality testing of antigen receptors. Herein, we defined similar patterns of lymphocytic infiltrates in hepatic biopsies of cats and correlated them with clonality to determine which patterns are predictive of lymphoma. A retrospective study was performed on surgical biopsies from 44 cats. The immunophenotype was characterized using CD3 and CD20 on all 44 samples. All 44 samples were tested using PCR for T-cell receptor gamma-gene rearrangements. PCR for immunoglobulin heavy chain gene rearrangements was performed on 24 of these cats. Four patterns of lymphocytic infiltrates were characterized: (1) tightly periportal, (2) periportal and centrilobular, (3) nodular, and (4) periportal with sinusoidal extension. Other histomorphologic features (fibrosis, biliary hyperplasia, bile ductopenia, bile duct targeting, hepatic hematopoiesis, lipogranulomas, lymphonodular aggregates, other inflammatory cells) were also evaluated. The sensitivity and specificity of the lymphocytic patterns to diagnose lymphomas were determined using Bayesian Hui–Walter analysis (BLCM) against clonality results. Lymphocytic patterns 2, 3, and 4 accurately diagnosed hepatic lymphomas with a sensitivity and specificity of 82% (CI 95%: 0.65, 0.96) and 77% (CI 95%: 0.54, 1.00), respectively. None of the other microscopic features evaluated were predictive of a lymphoma or inflammation. Our study identified specific patterns of lymphocytic infiltration that differentiate feline hepatic lymphoma from inflammation while other histologic features were not associated with an accurate diagnosis. [ABSTRACT FROM AUTHOR]

Primary hepatic lymphoma is rare. Clinical and radiological presentations are not specific. The diagnosis is often late. Chronic hepatitis or cirrhosis, especially post-viral C usually precedes primary liver lymphoma. The differential diagnosis arises mainly with other hepatic tumors, such as atypical hypovascular cellular hepatocellular carcinoma when there is liver cirrhosis and with hypovascular hepatic metastases, especially colorectal, stomach and lung metastases. Other differential diagnosis are tuberculosis or sarcoidosis, particularly when there is multiple lesions.We report the case of a 52-year woman, with a history of hepatitis C infection, presenting liver cirrhosis with multiple hepatic lesions. Radiological aspect was not specific which makes it difficult to distinguish from other hepatic tumors, especially hypovascular liver metastases.

Graft versus host disease (GVHD) is a common complication following allogeneic hematopoietic cell transplantation (HCT) that typically manifests as injury to the skin, gastrointestinal mucosa, and liver. In some cases, hepatic GVHD may be histologically indistinguishable from other disorders such as infection and drug-induced liver injury (DILI). Additionally, clinical signs and symptoms are frequently confounded by the superimposed effects of pretransplant chemoradiotherapy, immunotherapy (IT) (targeted to the underlying malignancy), GVHD prophylaxis, and infection. Thus, careful attention to and correlation with clinical findings, laboratory values, and histologic features is essential for diagnosis. This review, aimed at the practicing pathologist, will discuss current clinical and histologic criteria for GVHD, the approach to diagnosis of hepatic GVHD, and features helpful for distinguishing it from other entities in the differential diagnosis.

Hepatic lymphoma is poorly characterized in cats and differentiating between inflammation and lymphomas is often difficult. The diagnosis of hepatic lymphoma in humans relies on recognition of specific patterns of lymphocytic infiltrates and clonality testing of antigen receptors. Herein, we defined similar patterns of lymphocytic infiltrates in hepatic biopsies of cats and correlated them with clonality to determine which patterns are predictive of lymphoma. A retrospective study was performed on surgical biopsies from 44 cats. The immunophenotype was characterized using CD3 and CD20 on all 44 samples. All 44 samples were tested using PCR for T-cell receptor gamma-gene rearrangements. PCR for immunoglobulin heavy chain gene rearrangements was performed on 24 of these cats. Four patterns of lymphocytic infiltrates were characterized: (1) tightly periportal, (2) periportal and centrilobular, (3) nodular, and (4) periportal with sinusoidal extension. Other histomorphologic features (fibrosis, biliary hyperplasia, bile ductopenia, bile duct targeting, hepatic hematopoiesis, lipogranulomas, lymphonodular aggregates, other inflammatory cells) were also evaluated. The sensitivity and specificity of the lymphocytic patterns to diagnose lymphomas were determined using Bayesian Hui–Walter analysis (BLCM) against clonality results. Lymphocytic patterns 2, 3, and 4 accurately diagnosed hepatic lymphomas with a sensitivity and specificity of 82% (CI 95%: 0.65, 0.96) and 77% (CI 95%: 0.54, 1.00), respectively. None of the other microscopic features evaluated were predictive of a lymphoma or inflammation. Our study identified specific patterns of lymphocytic infiltration that differentiate feline hepatic lymphoma from inflammation while other histologic features were not associated with an accurate diagnosis.

Diffuse large B-cell lymphoma (DLBCL) is the most prevalent type of non-Hodgkin lymphoma (NHL), and typically presents in patients who are at least 60 years old with gastrointestinal (GI) tract involvement. We report a case of a young patient with DLBCL. A 27-year-old African American male presented to the emergency room with complaints of abdominal distention. Imaging showed hepatosplenomegaly with multiple nodular lesions in both the liver and spleen. The biopsy confirmed a diagnosis of DLBCL. This case report highlights a rare clinical presentation of DLBCL due to the uncommon hepatic initial presentation of the disease paired with the patient's age and race varying significantly from the demographic norm. Clinicians should maintain a high index of suspicion for DLBCL in patients with atypical extranodal involvement, such as in this patient, to optimize patient outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Drzymalski et al.)

Purpose: This study aimed to explore the ability of texture parameters combining with machine learning methods in distinguishing intrahepatic cholangiocarcinoma (ICCA) and hepatic lymphoma (HL). Method: A total of 28 patients with HL and 101 patients with ICCA were included. A total of 45 texture features were extracted by the software LifeX from contrast-enhanced computer tomography (CECT) images and 38 of them were eligible. A total of 5 feature selection methods and 9 feature classification methods were used to build the best diagnostic models, combining with the 10-fold cross-validation to assess the accuracy of these models. The discriminative ability of each model was evaluated by receiver operating characteristic analysis. Result: A total of 45 predictive models were built by the cross combination of each selection and classification method to differentiate ICCA from HL. According to the results of test group, most of the models performed well with a large area under the curve (AUC) (>0.85) and high accuracy (>0.85). Random Forest (RF)_Linear Discriminant Analysis (LDA) (AUC = 0.997, accuracy = 0.969) was the best model among all the 45 models. Conclusion: Combining texture parameters from CECT with multiple machine learning models can differentiate ICCA and HL effectively, and RF_LDA performed the best in this process. [ABSTRACT FROM AUTHOR]

Acute liver failure (ALF) is a relatively rare presentation of non-Hodgkin lymphoma, often found only during postmortem examination in patients. We treated a 33-year-old woman with prominent jaundice who was diagnosed with diffuse large B-cell lymphoma presenting as ALF. We could not perform liver biopsy during the critical phase because of coagulopathy, but gastric biopsy showed the infiltration of lymphoma cells. The patient was successfully treated with rituximab and chemotherapy and she survived. Malignant lymphoma should be considered in the differential diagnosis of patients who show liver dysfunction, and biopsy should be performed.

Background: Macrophage‐like (ML) cells are rarely observed on blood smear examinations, and the significance of these cells has been poorly described. Objective: The objective of this study was to retrospectively describe selected hematologic and clinical characteristics of dogs with ML cells in peripheral blood. Materials and Methods: Complete blood count (CBC) reports with blood smear evaluations from the clinical pathology laboratory records at North Carolina University College of Veterinary Medicine were retrospectively reviewed. Data were collected over a 10‐year‐period. Dogs were defined as having circulating ML cells if three or more ML cells were present on a single blood smear. Hematologic and clinical data of dogs with circulating ML cells were compared with age‐matched hospital‐derived control dogs. Results: Of 61,631 CBC records, 87 reports (0.14%) described the presence of ML cells. Thirty‐nine dogs met the inclusion criteria. The hemogram of dogs with circulating ML cells was characterized by a pronounced inflammatory and stress leukogram, anemia, and thrombocytopenia. Of the 39 dogs, 19 (49%) had systemic or severe localized inflammatory/necrotic diseases. Eighteen (46%) dogs were diagnosed with neoplasia of histiocytic (5) and non‐histiocytic origins (13). Dogs with circulating ML cells had a shorter median survival time (34 days) than the control dogs (595 days, P <.0001), with an increased occurrence of death/euthanasia within 1 month (3.89‐fold). However, the presence of circulating ML cells was not found to be an independent prognostic factor in a multivariable model. Conclusions: The hemograms and diagnoses of dogs with ML cells suggest that severe inflammatory conditions or histiocytic and non‐histiocytic neoplasia are common causes for circulating ML cells. [ABSTRACT FROM AUTHOR]

Extramarginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) is a non-Hodgkin lymphoma of low-grade malignancy. The most common localization is the stomach, and the common nongastric sites are salivary glands, the skin, orbits, the conjunctiva, the lung, breasts, upper airways, other gastrointestinal sites, and the liver. Primary hepatic MALT lymphoma is a rare disease and the diagnostic can be challenging. The clinical presentation is nonspecific and may range from no symptoms to end-stage liver disease. The radiological aspect of hepatic lymphoma may indicate this diagnosis; however, the final diagnosis is made by hepatic biopsy. We report the case of a 47-year-old woman with no chronic liver disease, incidentally found with a focal liver mass at ultrasound examination. The only clinical symptom was fatigue. The blood tests were normal and tumoral markers were negative. Computed tomography and magnetic resonance imaging were performed. However, because the hepatic lesion was first described as a benign entity and, at second opinion, the suspicion of lymphoma was raised, the patient decided to undergo surgery first, without prior biopsy. The histopathologic analysis confirmed the diagnosis: hepatic MALT lymphoma positive for CD 20 and negative for CD 5, BCL6, cyclin D1, and CD 23. No lymph node involvement was noted and follow-up imaging with positron emission tomography-computed tomography did not show any other site of disease, thus confirming the diagnosis of primary hepatic MALT lymphoma. The aim of this paper was to highlight the imagistic features of primary hepatic lymphoma to contribute to the early diagnosis of this rare disease entity.

Objectives: This study compared the diagnostic ability of image-based parameters with texture parameters in the differentiation of hepatocellular carcinoma (HCC) and hepatic lymphoma (HL) by positron emission tomography–computed tomography (PET/CT).Methods: Patients with pathological diagnosis of HCC and HL were included in this study. Image-based and texture parameters were obtained by manual drawing of region of interest. Receiver operating characteristic (ROC) was used to test the diagnostic capacity of each parameter. Binary logistic regression was used to transform the most discriminative image-based parameters, texture parameters, and the combination of these parameters into three regression models. ROC was used to test the diagnostic capacity of these models.Result: Ninety-nine patients diagnosed with HCC (n = 76) and HL (n = 23, 10 primary HL, 13 secondary HL) by histological examination were included in this study (From 2011 to 2018, West China hospital). According to the AUC and p-value, 2 image-based parameters and five texture parameters were selected. The diagnostic ability of texture-based model was better than that of image-based model, and after combination of those two groups of parameters the diagnostic capacity improved.Conclusion: Texture parameters can differentiate HCC from HL quantitatively and improve the diagnostic ability of image-based parameters.

Objectives: This study compared the diagnostic ability of image-based parameters with texture parameters in the differentiation of hepatocellular carcinoma (HCC) and hepatic lymphoma (HL) by positron emission tomography–computed tomography (PET/CT). Methods: Patients with pathological diagnosis of HCC and HL were included in this study. Image-based and texture parameters were obtained by manual drawing of region of interest. Receiver operating characteristic (ROC) was used to test the diagnostic capacity of each parameter. Binary logistic regression was used to transform the most discriminative image-based parameters, texture parameters, and the combination of these parameters into three regression models. ROC was used to test the diagnostic capacity of these models. Result: Ninety-nine patients diagnosed with HCC (n = 76) and HL (n = 23, 10 primary HL, 13 secondary HL) by histological examination were included in this study (From 2011 to 2018, West China hospital). According to the AUC and p -value, 2 image-based parameters and five texture parameters were selected. The diagnostic ability of texture-based model was better than that of image-based model, and after combination of those two groups of parameters the diagnostic capacity improved. Conclusion: Texture parameters can differentiate HCC from HL quantitatively and improve the diagnostic ability of image-based parameters. [ABSTRACT FROM AUTHOR]

Acute liver failure (ALF) is a relatively rare presentation of non-Hodgkin lymphoma, often found only during postmortem examination in patients. We treated a 33-year-old woman with prominent jaundice who was diagnosed with diffuse large B-cell lymphoma presenting as ALF. We could not perform liver biopsy during the critical phase because of coagulopathy, but gastric biopsy showed the infiltration of lymphoma cells. The patient was successfully treated with rituximab and chemotherapy and she survived. Malignant lymphoma should be considered in the differential diagnosis of patients who show liver dysfunction, and biopsy should be performed. [ABSTRACT FROM AUTHOR]

Primary hepatic lymphoma (PHL) is defined as a lympho-proliferative disorder limited to the liver without any involvement of the spleen, lymph nodes, bone marrow or blood. Diffuse large B-cell lymphoma (DLBCL) is the most common histological type counting more than 60–80% of all PHL. Usually, it occurs in middle-aged men with aspecific symptoms and diagnosis is confirmed by histopathology. In order to expand current knowledge and to investigate an optimal therapeutic strategy, a systematic review of literature was conducted in February 2016. A total of 274 articles were retrieved, and after exclusion, 55 were retained, reporting 147 cases of PHL. Patients were mainly men (64.9%) with a median age at diagnosis of 57 years (range: 17–92) and right hepatic lobe involvement (69.6%). Among the 147 patients, 9% received no therapy while 77% underwent treatment including chemotherapy, surgery and radiotherapy in 64%, 26% and 1% of cases, respectively. Mean follow-up was 22.6 months (range: 0.2–360). Overall mortality was 29.2% with a 90-day mortality of 26%. Risk factors for increased mortality include; bilobar lesions ( p  = 0.001), right lobe localisation ( p  = 0.003) and non-surgical approach or the absence of any treatment ( p  = 0.001). A trend towards favourable outcomes for young patients (mean = 50.4 years) with a large liver lesion was achieved by surgical management of PHL but this did not achieve statistical significance. Statistical analysis indicates that in cases of resectable disease, an aggressive surgical approach in selected patients leads to increase long-term survival. Thus, two hypotheses should be assessed in further randomized studies: 1°) resectable PHL is a less severe form or 2°) hepatectomy is an effective treatment for PHL. [ABSTRACT FROM AUTHOR]

The aim of the present study was to delineate the radiographic and clinical features of primary hepatic lymphoma (PHL). Four histopathologically confirmed cases of PHL were analyzed with respect to the radiological, clinical and pathological characteristics. The main clinical manifestations included upper right quadrant pain and lymphoma-associated B symptoms, such as fever, night sweating and weight loss. All the patients had elevated serum levels of lactate dehydrogenase. Furthermore, all the patients underwent plain and enhanced computed tomography examinations, which identified low-density lesions without marked enhancement. Solitary masses were observed in two cases, while multiple focal lesions were noted in one case and diffuse multi-speckled nodules were observed in one case. Two patients underwent abdominal magnetic resonance imaging, which revealed lesions that were hyperintense on T1-weighted imaging (WI) scans and hypointense on T2WI scans, and exhibited slight to moderate enhancement with a dynamic contrast-enhanced protocol. In one case, vessels were visible within the lesion. Therefore, the present study concluded that PHL is a rare condition that exhibits non-specific clinical and radiological features. A combination of imaging results and clinical manifestations can be used to facilitate a diagnosis of PHL. [ABSTRACT FROM AUTHOR]

Primary hepatic lymphoma (PHL) was a rare malignancy usually presenting with abdominal pain, malaise, Hepatomegaly, B-symptoms, fatigue, nausea, vomiting and jaundice. It mostly involves liver without any palpable lymphadenopathy and leukemia in peripheral blood smear. On July 22,2014, a 64 year old man presented with abdominal pain localizing in Right upper quadrant and fullness from 2 years ago without any wight loss or constitutional symptoms. His physical examination revealed no mass or lymphadenopathy and lab data showed rise in Alkaline phosphatase(ALP) and Gamma-glutamyl transferase(gamma-GT). Abdominal computed tomography(CT) scan with contrast showed a calcified lesion in the left lobe of liver and illdefined hypodense area in medial segment of the left lobe of liver adjacent to gallbladder associated with mild central intra hepatic bile ducts dilation showing more enhancement in delay phase suggested peripheral cholangiocarcinoma. Finally surgical core needle biopsy of the liver confirmed malignant lymphoma of B cell type and patient was referred to oncologist for chemotherapy. His chemotherapy regimen consisted of rituximab 600 milligram (mg), endoxan 1250 mg, adriamycin 80 mg, vincristine 2 mg, prednisolone 100 mg (during five days) for 6 courses. After 5 months chemotherapy, on December 22,2014 a follow up CT scan with IV and oral contrast was done. There was no evidence of previous mass lesion in the liver. In the follow up on May 9,2015, he had no specific symptoms and all of his lab data were in normal range. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 13-year-old male cheetah presented with a history of lateral recumbency and anorexia at the Zoological Medicine Service of Kansas State University. The cheetah underwent a physical examination under general anesthesia which reveal the presence of a severe icterus and total bilirubin and alanine transaminase. The cheetah was treated with the immobilization of butorphanol and midazolam.

Copyright of Journal Africain D'Hépato-Gastroentérologie is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Primary extranodal lymphomas are much less frequent than nodal lymphomas. Osseous and hepatic lymphomas commonly present with additional nodal lesions. Primary lymphoma of the bone or of the liver without nodal disease is uncommon. We describe a case of extranodal non-Hodgkin''s lymphoma with numerous osseous and hepatic lesions without any lymph node involvement on FDG-PET/CT images. This is the first report of the coexistence of both osseous and hepatic lymphoma in the same patient without any lymph node involvement. [Copyright &y& Elsevier]

Abstract: We review the literature on primary hepatic lymphoma (PHL). PHL is a rare malignancy, and constitutes about 0.016% of all cases of non-Hodgkin''s lymphoma. It has been reported to occur with increased frequency in patients with chronic hepatitis C infection. Most patients with PHL present with abdominal pain, constitutional symptoms and have hepatomegaly on examination. Imaging studies reveal solitary, or less often, multiple masses in the liver. The predominant histology is B-cell lymphoma, most commonly diffuse large cell type. Most patients are treated with chemotherapy, with some physicians employing a multimodality approach incorporating surgery and radiotherapy with chemotherapy. The prognosis is variable, with good response to early aggressive combination chemotherapy. [Copyright &y& Elsevier]

A 51-year-old woman presented to the outpatient clinic with appetite loss and abdominal pain that had persisted for 1 month. Computed tomography (CT) showed a bulky tumor in the right liver, with hepatosplenomegaly and lymphadenopathy in several para-aortic lymph nodes. The diagnosis of diffuse large B-cell lymphoma was confirmed by a biopsy of a submucosal tumor in the stomach. Bone marrow invasion by lymphoma cells was observed. On day5 after a rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) regimen was initiated, epigastralgia and right hypochondralgia were noted. On day6, severe anemia (hemoglobin level, 4.2 g/dl) developed. Repeat CT showed a low-density area surrounding the hepatic tumor caused by tumor lysis, and hepatic tumor rupture was suspected. Transfusion was performed, and no signs of recurrence of bleeding were noted after the procedure. On day21, angiography of the hepatic artery showed no signs of bleeding. After two cycles of R-CVP therapy and eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, partial remission was achieved. In this report, we present a rare case of patient survival following hepatic tumor rupture associated with hepatic lymphoma after treatment.