Spontaneous Regression of Hepatic Diffuse Large B-cell Lymphoma in HIV and HCV Positive Patient: A Novel Case Study

Abstract

Objective/Background: Diffuse large B-cell lymphoma (DLBCL) rarely occurs in the liver. Spontaneous regression of this tumor is extremely rare. We are reporting the first case of hepatic DLBCL, and we are reviewing the English literature for cases of spontaneous regression of DLBCL and cancer in general. Methods: A 60-year-old gentleman with a history of HIV and HCV infections presented with an incidental liver mass. He was diagnosed with DLBCL germinal cell type with high grade features based on the results of pathological/cytogenetics studies. He started HCV and HIV medication but refused lymphoma chemotherapy. Results: Radiological follow up during a four-year period showed a spontaneous regression of his liver mass to a non-detectable size. Review of the English literature revealed 18 cases of DLBCL spontaneous regression, none of which were found in the liver. Here, two mechanisms are proposed to explain this phenomenon; the immunologic and the genetic. Conclusion: Chemoimmunotherapy is recommended for all DLBCL patients. However, this case of DLBCL spontaneous regression in an HIV and HCV positive patient offers a rare platform to understand the immune and genetic mechanisms for cancer and lymphoma in particular.