PRIMARY DIFFUSE LARGE B CELL LYMPHOMA OF THE COMMON BILE DUCT: A CASE REPORT AND LITERATURE REVIEW

Non-Hodgkin lymphoma of the extra hepatic bile ducts is extremely rare, more often it is a result of a secondary involvement in the systemic disease. In the Pub Med database we found only 7 reports presenting primary diffuse large B cell lymphoma of the common bile duct.

We present a case of 56 years old male patient with an intramural lesion of the common bile duct that was found while performing cholecystectomy for cholelithiasis. Consequently resection of the common bill duct with Roux-en-Y hepaticojejunostomy was performed. The histopathology examination and Immunohistochemical staining revealed primary diffuse large cell B lymphoma of the common bile duct. The patient was referred to an oncology institution and was submitted to a combination chemotherapy using the R-CHOP protocol (Rituximab, Cyclophosphamide, Hydroxydaunorubicin, Oncovin and Prednisone).

Primary lymphoma of the common bile duct is rare, but it should be considered as a differential diagnosis in extra hepatic bile duct obstruction. The histopathology finding is usually obtained from a surgical specimen and it is crucial for patients to receive adequate cancer therapy. Yet the best treatment modality is still to be defined.