Clinical features

The most frequent presenting symptoms are right upper abdominal/epigastric pain or discomfort, weight loss and fever {1043, 1217}. Most cases are solitary or multiple masses within the liver which may be misdiagnosed as a primary liver tumour or metastatic cancer {1043, 1217}. Some cases have been reported with diffuse infiltration of the liver associated with hepatomegaly but without a discrete mass, simulating hepatic inflammation {668}.

Hepatosplenic T-cell lymphomas present with hepatosplenomegaly, usually without peripheral lymphadenopathy and without lymphocytosis. There is almost always thrombocytopenia and most patients are anaemic. Liver function tests are usually abnormal with moderate elevation of levels of transaminases and alkaline phos-phatase. Serum lactate dehydrogenase level may be very high {334}.

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