Primary splenic diffuse large B-cell lymphoma: a case report (original) (raw)
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Primary Splenic Diffuse Large B Cell Lymphoma. Case Report and Literature Review
SN Comprehensive Clinical Medicine, 2020
We report a case of a localized, massive, diffuse large B cell splenic lymphoma diagnosed by splenectomy. A 61-year-old man complaining of abdominal pain was admitted to our hospital. On abdominal tomography examination, there was seen to be a significant increase in the spleen dimensions and a lesion of heterogenous density was observed to be covering almost all of the spleen parenchyma. Intraoperatively, a massive hematoma involving approximately 95% of the spleen and ischemic areas were observed, so it was decided to perform splenectomy. With an improvement in general condition and no active complaints, the patient was discharged, but then failed to attend for follow-up examinations. At 7 months after the splenectomy, the patient again presented at the Emergency Department with complaints of abdominal pain, nausea, and vomiting. On abdominal tomography, a solid mass was observed, approximately 12 × 9 cm in size with irregular contours in the margins of the splenectomy location. The diagnosis was reported as non-germinal center diffuse large B cell lymphoma showing involvement with the colon and small intestine segments. It was learned that the patient had not attended follow-up examinations and when the splenectomy material of 17.5 × 13.5 × 6 cm was examined, it was reported as non-germinal center diffuse large B cell lymphoma. This case is of importance in respect of the development of recurrence in less than a year as splenectomy only without systemic chemotherapy was insufficient in the treatment of diffuse large B cell lymphoma with isolated spleen involvement.
Diffuse Large B cell Lymphoma with Primary Spleen Involvement: Report of Three Cases
Medicine Science | International Medical Journal, 2014
The spleen is the primary organ of lymphoma in only 1-2 % of all lymphoma patients. We presented three cases of primary splenic involvement of lymphoma that were treated. Presentation of cases: In the first case, four solid lesions were detected, and in the second case, a hypodense lesion of 3 cm was detected in the spleen. Two cases underwent splenectomy. No complication and recurrence were observed during 22-21 months followup, respectively. In the third case, a splenic mass invading pancreas was detected. Splenectomy and distal pancreatectomy were performed. No recurrence was observed during 8-year follow-up. In postoperative period, all cases were treated with cyclophosphamide, vincristine, doxorubicin, prednisone plus rituximab for 6 cycles. Primary splenic lymphoma refers to the involvement of the spleen only or with splenic hilar lymph node or local invasion without liver involvement. The pathologic diagnosis was diffuse large B-cell non-Hodgkin's lymphoma in the all cases. Splenic mass biopsy has some complication risks. Aspiration biopsy of splenic mass was performed in one of the three cases. Invasions should be evaluated in terms of malignity during splenectomy, and liver biopsy and biopsies of lymph nodes can be performed in case of lymphoma. Additionally diagnosis should be confirmed via postoperative bone marrow biopsy and positron emission tomography screening. Primary splenic involved lymphoma must be kept in mind for differential diagnosis in cases with splenic mass. Splenectomy is one of the most common modality for primary splenic lymphomas in terms of both diagnostic and curative treatment.
Clinical Medicine Insights: Blood Disorders
The spleen is among the most common extranodal sites for Hodgkin and non-Hodgkin lymphomas (NHLs); however, among lymphomas arising from the spleen, primary splenic lymphomas (PSLs) are rare. The group of PSLs includes primary splenic diffuse large B-cell lymphoma (PS-DLBCL), splenic red pulp small B-cell lymphoma, splenic marginal zone lymphoma (SMZL), and a splenic hairy cell leukemia variant. Delineating between the PSL variants can be challenging, especially as fine-needle aspirate and core needle biopsy of the spleen are not routinely offered at most medical centers. Herein, we describe the clinical course of 2 representative patients who presented with non-specific gastrointestinal symptoms, the first who was diagnosed with PS-DLBCL and the second who was diagnosed with SMZL. We review and contrast the clinical presentations, imaging techniques, and laboratory findings of these discrete lymphoma variants and offer strategies on how to delineate between these varied splenic pro...
Primary splenic diffuse large B‐cell lymphoma presenting as a splenic abscess
eJHaem
Diffuse large B-cell lymphoma (DLBCL) arising in the spleen, also known as primary splenic DLBCL (PS-DLBCL), is a rare form of malignant lymphoma. It is defined as a lymphoma confined to the spleen or involving splenic hilar lymph nodes. Here we report a case of PS-DLBCL with CD30. The patient was a 62-year-old who presented with 2 weeks of left flank pain, chills, and abdominal distension. Computed tomography identified an 8-cm splenic mass with central necrosis interpreted as an abscess. A drain was placed, yielding purulent necrotic material; cytologically, only neutrophils were identified. However, purulent drainage continued for 28 days without resolution, prompting splenectomy. Pathological dissection revealed a multinodular mass with central necrosis. Microscopic examination revealed extensive karyorrhexis, abundant ghosts of large cells, and scattered large cells with pleomorphic, multilobated, and vesicular nuclei with moderately abundant cytoplasm. Immunohistochemical staining revealed large,
Primary Splenic Diffuse Large B Cell Lymphoma after Splenectomy: A Rare Case with Literatur Review
American Journal of Medical Case Reports, 2015
Primary splenic diffuse large B cell lymphoma is rarely clinical entity and comprises 1% of all malignant lymphomas. The spleen is also involved in immune defense against blood-borne antigens. Though the haematological malignancies, spleen is usually affected as a part of multisystemic involvement rather than isolated involvement. More than half of patients affected by Hodgkin's disease and about a third of those with non-Hodgkin lymphoma have splenic involvement. The involved spleen may be complicated with rupture due to massive splenomegaly, which may need urgent intervention. In this report, we present a 47-year-old female patient with massive splenomegaly, who was diagnosed with primary splenic diffuse large B cell lymphoma after splenectomy.
PRIMARY LYMPHOMA OF THE SPLEEN. REPORT OF A CASE WITH DIAGNOSIS BY FINE-NEEDLE GUIDED BIOPSY
1995
Primary splenic lymphoma is a relatively infrequent disease; the diagnosis of this entity is cur- rently made with splenectomy. In a 52-year-old female with left upper quadrant abdominal pain, ultrasound showed a normal-sized spleen with an internal hypoechoic focal lesion. Ultrasonically- guided fine-needle aspiration and tissue core biopsy of the splenic lesion showed non-Hodgkin's lymphoma (NHL). At the time of presentation there was no evidence of involvement of lymph nodes, bone marrow or any other organ. A diagnosis of primary splenic non-Hodgkin's lymphoma was made and the patient underwent laparotomy with splenectomy. Histologic examination of the spleen confirmed the diagnosis: low-grade NHL confined to the spleen. The patient is well and in complete remission seven months after diagnosis. The purpose of this paper is to report a rare occurrence of primary splenic lymphoma and to demonstrate the possibility of making this diagnosis by percutaneous guided biopsy.
Primary splenic anaplastic variant of diffuse large B-cell lymphoma: a case report
Journal of Medical Case Reports
Background Primary splenic lymphoma represents a rare entity that constitutes less than 1% of non-Hodgkin lymphomas, and less than 2% of all lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype of primary splenic lymphomas. DLBCL encompasses a heterogeneous entity with distinct morphological variants. The anaplastic variant of DLBCL was first defined in the 2017 World Health Organization classification as a rare histological subtype that constitutes less than 3.4% of DLBCL cases. Case presentation A 65-year-old Syrian man presented to our hospital with constant dull localized left upper quadrant abdominal pain for about 20 days accompanied by general weakness, loss of appetite, and rapid weight loss. Clinical examination revealed isolated splenomegaly and left upper abdominal tenderness. Following physical, laboratory, and radiologic examinations, the patient underwent splenectomy. Interestingly, pathological and immunohistochemical examinations o...
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.3\_March2017/IJHSR\_Abstract.053.html, 2017
Splenic lymphoma is an indolent form of mature B-cell neoplasm. It is very rare and overlaps with other lymphomas. The hall mark of clinical presentation is splenomegaly and it usually becomes symptomatic when spleen becomes massive and associated with cytopenia. We discuss here about a 48yr old female with malignant non Hodgkin's lymphoma-spleen. The case is published for its rarity.
Surgical approach of primary splenic lymphoma: report of a case and review of the literature
Indian Journal of Hematology and Blood Transfusion, 2009
A 80-year-old woman was hospitalized due to anemia and fever. Computed tomography depicted a solitary concentric, sharply marginated lesion of the spleen. Laparotomy identifi ed a creamy-white soft tumor. Histopathological examination confi rmed the diagnosis of non-Hodgkin B-cells anaplastic lymphoma. Extended range of pathological manifestations explains the variety of radiological appearances and diffi culty in accurate diagnostic process of primary splenic lymphoma.
Primary non-Hodgkin lymphoma of the spleen
American Journal of Hematology, 1991
Primary splenic lymphoma is a relatively infrequent cause of splenomegaly, its reported incidence being less than 1%. Nonetheless, various series have reported on its occurrence and its unfavorable prognosis, but these series have reported data on heterogenous populations, including many patients with nodal or hepatic disease. We report on a series of nine patients with primary splenic lymphoma. None of these patients had biopsy-proven evidence of extrasplenic disease and were categorized as involving spleen only (stage 1) or spleen and splenic hilum (stage 2). In this series, classified by the recent N.C.I. working formulation, four patients had intermediate or high-grade histology and five patients had low-grade histology. There was no correlation between histological subtype and prognosis, nor could other factors be delineated to explain their favorable prognosis. The median survival in this group of patients was 7.48 years, and no evidence of relapse has been documented. The data suggest that primary splenic lymphoma, treated by splenectomy alone or combination therapy, may be potentially curative. Further studies should address the question of aggressive accurate staging in hopes of obtaining homogenous patient populations so that appropriate treatment in primary splenic lymphoma can be better defined .