Primary Splenic Diffuse Large B Cell Lymphoma. Case Report and Literature Review
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MEDICINE
Primary Splenic Diffuse Large B Cell Lymphoma. Case Report and Literature Review Hacer Berna Afacan Öztürk 1 Pınar Cömert 1 & Ünsal Han 2
& Murat Albayrak & Çiğdem Pala & Abdulkerim Yıldız & Senem Maral & Osman Şahin & 1
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Accepted: 13 September 2020 # Springer Nature Switzerland AG 2020
Abstract 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. Keywords Diffuse large B cell lymphoma . Primary splenic . Splenectomy . Treatment . Splenic lymphoma
Introduction Despite the frequent finding of spleen involvement in patients with non-Hodgkin lymphoma (NHL), primary malignant lymphoma of the spleen without other organ involvement and lymphadenopathy is very rare and constitutes 1% of all malignant lymphomas [1]. In patients with moderate to massive splenomegaly, the most frequently seen symptom is left upper quadrant pain and early This article is part of the Topical Collection on Medicine * Hacer Berna Afacan Öztürk [email protected] 1
Diskapi Yildirim Beyazit Training and Research Hospital, Department of Hematology, University of Health Sciences, Ankara, Turkey
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Diskapi Yildirim Beyazit Training and Research Hospital, Department of Pathology, University of Health Sciences, Ankara, Turkey
satiation due to gastric compression. The presence of tumor with splenomegaly is most commonly seen in lymphomas in different malignancies [2].
Case A 61-year-old male presented at the Emergency Department following a fall while walking 2 days previously; pain had occurred in the left up
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