Concurrent and apposed hepatocellular carcinoma and small lymphocytic lymphoma/chronic lymphocytic leukemia in a patient with hepatitis C virus.

A patient with chronic hepatitis C virus (HCV) presented to our clinic with a hepatic mass as well as lymphocytosis. Biopsy of the hepatic mass revealed apposed hepatocellular carcinoma (HCC) and small lymphocytic lymphoma (SLL)/chronic lymphocytic leukemia (CLL). Dramatic examples of lymphoma regression during treatment with antiviral medication in chronic HCV patients have suggested an etiologic role for HCV in lymphomagenesis. A growing body of research seeks to clarify the details of the interaction between HCV and B-cell lymphomas. This case of adjacent SLL/CLL and HCC is the first published diagnosis of these two diseases in the liver at one time, and the only published example of the physical apposition of any lymphoma and HCC. The case is provocative in light of recent evidence that local interactions between HCV-infected hepatocytes and B cells may contribute to lymphomagenesis. Copyright 2009 S. Karger AG, Basel.