Primary hepatic follicular lymphoma 5 years post sustained virological response from hepatitis C viral infection

Correspondence to Dr Tomonari Shimagaki, Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan; tomo_s@surg2.med.kyushu-u.ac.jp Clinical question A 72-year-old man who was treated with a combination of simeprevir with peginterferon and ribavirin for hepatitis C virus (HCV) infection (genotype 1b) 5 years ago and has been treated as sustained virological response, was found to have a 2.6 cm tumourous lesion in the medial segment of the liver. Primary hepatic follicular lymphoma is extremely rare and accounts for only 1%–4.4% of PHLs.1 HCV-infected patients are prone to develop bone marrow or various other tissue infiltrates with monoclonal B-cells, monoclonal B lymphocytosis or different types of B-cell non-Hodgkin’s lymphoma.1 2 Also, antiviral therapy reduces the risk of lymphoma in patients with chronic HCV infection.3 To the best of our knowledge, this is the first reported case of the appearance of primary hepatic follicular lymphoma, with the risk of lymphoma being reduced after the virus has disappeared. N Engl J Med 2016; 375: 1699–701. doi:10.1056/NEJMc1513288 http://www.ncbi.nlm.nih.gov/pubmed/27783921 4 Williams M-JO, Akhondi H, Khan O. Primary hepatic follicular lymphoma presenting as sub-acute liver failure: a case report and review of the literature.