Severe Haemorrhage after Liver Biopsy of Malignant B-Cell Lymphoma Mimicking Hepatic Infection

Introduction

Fever of unknown origin (FUO) is a challenging diagnostic problem, since the underlying cause remains unidentified for a long time, even with frequent diagnostic procedures. We report about a patient with FUO and a suspicious liver lesion detected by FDG-PET/CT. CT-guided diagnostic biopsy of the lesion caused haemodynamically relevant haemorrhage that could only be solved by immediate endovascular coil embolization. Biopsy specimens revealed malignant B cell lymphoma as the cause of FUO and adequate treatment was initiated. Our case demonstrates the need for early diagnostic CT-guided punctures of suspicious lesions in patients with FUO to establish the correct diagnosis and treatment. Furthermore it highlights relevant haemorrhage as one of the possible complications of diagnostic liver biopsies, which can be successfully treated by endovascular coil embolization.