Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a primary hepatic lymphoma, reporting [duration] of progressive right upper quadrant (RUQ) abdominal pain, constitutional B-symptoms including unexplained weight loss, night sweats, and persistent low-grade fevers. Denies history of chronic viral hepatitis or cirrhosis. Physical examination reveals hepatomegaly without evidence of extrahepatic lymphadenopathy.
Clinical Examination Findings
General: Patient appears [well/ill]-appearing, cachectic. Abdomen: Distended with palpable hepatomegaly, firm, non-tender, no evidence of splenomegaly or ascites. Skin: No jaundice, spider angiomata, or palmar erythema noted. Lymphatics: No palpable cervical, supraclavicular, or axillary lymphadenopathy.
Treatment Protocol
Therapeutic plan: Initiate multi-agent systemic chemotherapy (e.g., R-CHOP regimen) as per oncology protocol. Monitor liver function tests (LFTs) and tumor markers. Consider image-guided core needle biopsy for definitive histopathological subtyping. Evaluate for potential hepatic artery embolization or radiotherapy if localized disease progression occurs.