CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
When Lymphoma Wears a Hepatic Mask: A Rare Case of CD5-Positive Diffuse Large B-Cell Lymphoma with Cholestatic Jaundice
Provisionally accepted
- 1Palestine Medical Complex, Ramallah, Palestine
- 2An-Najah National University, Nablus, Palestine
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Background: Diffuse large B-cell lymphoma (DLBCL) is the most prevalent subtype of non-Hodgkin lymphoma, commonly manifesƟng as nodal or extranodal masses. However, unusual symptoms resembling primary hepatobiliary illness may postpone diagnosis and complicate care. CD5-posiƟve DLBCL is an uncommon and aggressive biological variaƟon that has a bad effect on prognosis. Case PresentaƟon: We discuss the case of a 46-year-old woman with well-managed hypertension who had severe cholestaƟc jaundice, hepatosplenomegaly, and systemic inflammaƟon. Tests in the lab showed hyperbilirubinemia, high alkaline phosphatase, progressive anemia, basophilia, monocytosis, and very high LDH values. At first, this pointed to a myeloproliferaƟve illness. Imaging ruled out biliary blockage but verified hepatosplenomegaly. A bone marrow biopsy showed that 85% of the cells were normal, but 30% were replaced with huge, unusual B cells that were posiƟve for CD20, CD10, BCL2, and CD5, and had a high Ki-67 index of 95%. Flow cytometry confirmed the results, leading to the diagnosis of CD5-posiƟve DLBCL, germinal center B-cell subtype, with significant marrow involvement. The paƟent began R-CHOP therapy following a corƟcosteroid pre-phase and experienced an infusion-related response to rituximab, which was effecƟvely addressed with supporƟve measures. Conclusion: This case demonstrates the importance of considering aggressive lymphomas in paƟents presenƟng with unexplained cholestaƟc jaundice and hepatosplenomegaly without biliary obstrucƟon on imaging. Early hematologic evaluaƟon and immunophenotypic characterizaƟon are important to avoid diagnosƟc delay and enable Ɵmely treatment.
Keywords: Atypical presentaƟon, Bone marrow involvement, CD5-posiƟve lymphoma, CholestaƟc jaundice, Diffuse large B-cell lymphoma (DLBCL), Hepatosplenomegaly, Immunohistochemistry, R-CHOP Chemotherapy
Received: 27 Oct 2025; Accepted: 05 Feb 2026.
Copyright: © 2026 Taha, Marouf, Salameh, AbuBaha, Sawalmah, Awad and AbuBaha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bara AbuBaha
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