Idiopathic cholestatis as a paraneoplastic phenomenon in Hodgkin's lymphoma Journal Article
| Authors: | Barta, S. K.; Yahalom, J.; Shia, J.; Hamlin, P. A. |
| Article Title: | Idiopathic cholestatis as a paraneoplastic phenomenon in Hodgkin's lymphoma |
| Abstract: | Paraneoplastic cholestasis is an uncommon presenting symptom in Hodgkin's lymphoma (HL). Two distinct entities causing this clinical picture have been described: idiopathic cholestasis and vanishing bile duct syndrome (VBDS). We report a patient with idiopathic cholestasis and early-stage HL with favorable risk factors whose liver biopsy results were consistent with intrahepatic cholestasis and no ductopenia. Other causes for cholestatic jaundice were ruled out. He was treated with subtotal lymphoid irradiation and subsequently experienced a steady improvement in his liver function tests to near normal over 21 months. This case illustrates a rare paraneoplastic phenomenon, and a review of the available literature is included. We also discuss the differences between HL-related idiopathic cholestasis and VBDS. The distinction between these 2 diseases has prognostic implications: idiopathic cholestasis is usually reversible in early-stage HL after treatment, whereas patients who develop VBDS commonly die from their disease. There is no established approach to the management of paraneoplastic cholestasis. We postulate that single-modality radiation therapy alone should be considered a valid treatment alternative in early-stage HL with idiopathic cholestasis. |
| Keywords: | adult; human tissue; treatment outcome; prednisone; histopathology; case report; hepatitis; cancer staging; positron emission tomography; treatment indication; metabolism; computer assisted tomography; radiation; risk factors; pathology; risk factor; biopsy; hodgkin disease; time; time factors; cancer regression; liver; nonhodgkin lymphoma; radiation dose fractionation; laboratory test; computer assisted emission tomography; positron-emission tomography; jaundice; physical examination; liver function test; paraneoplastic syndrome; liver biopsy; percutaneous biopsy; cholestasis; bile duct; bile ducts; idiopathic disease; intrahepatic cholestasis; paraneoplastic syndromes; vanishing bile duct syndrome |
| Journal Title: | Clinical Lymphoma and Myeloma |
| Volume: | 7 |
| Issue: | 1 |
| ISSN: | 1557-9190 |
| Publisher: | Cancer Information Group |
| Date Published: | 2006-07-01 |
| Start Page: | 77 |
| End Page: | 82 |
| Language: | English |
| DOI: | 10.3816/CLM.2006.n.044 |
| PUBMED: | 16879775 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 4 June 2012" - "Source: Scopus" |
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