B-Cell Lymphoma Diagnosed in an Explanted Liver of a Patient With Metabolic Dysfunction–Associated Steatohepatitis Cirrhosis

Hepatic malignancies in explanted livers are not uncommon; however, finding primary nonhepatic malignancies in explanted livers of any etiology is very rare. Given its rarity, we present a case of low-grade B-cell lymphoma in the liver explant of a patient with metabolic dysfunction-associated steatohepatitis cirrhosis after orthotopic liver transplantation. Preorthotopic liver transplantation workup was notable for periportal lymphadenopathy that was negative for malignancy per ultrasound-guided biopsy, so this finding was surprising. This unexpected diagnosis of lymphoma despite negative workup during pretransplant evaluation underscores the importance for liver transplant centers to conduct thorough investigations for malignancies before transplantation.