Primary Splenic Lymphoma Associated with Hemophagocytic Lymphohistiocytosis Complicated with Splenic Rupture

Han, Sheng; Teng, Chieh‐Lin Jerry; Hwang, Guang-Yuh; Chou, Guan; Tsai, Che-An

doi:10.1016/s1726-4901(08)70106-0

Cited by 18 publications

(13 citation statements)

References 13 publications

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“…According to existing literature, splenic lymphoma can have different clinical manifestations that may simply include abdominal discomfort or spleen enlargement without any other abnormalities. Besides being used for diagnosing the splenic lymphoma, splenectomy is also used to treat splenic lymphoma [ 4 , 7 , 9 ]. It is a feasible surgical method that allows for abdominal exploration of other potential illnesses.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous occurrence of splenic diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report

et al. 2018

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BackgroundAlthough the primary malignant spleen tumor is relatively rare, lymphoma is the most common splenic malignancy. It can have quite different clinical manifestations that usually lead to relatively poor outcomes, and thus early and accurate diagnosis are of utmost importance.Case presentationThe present study reports a case of a 67-year-old female with high fever, abnormal spleen (diagnosed by PET/CT) and no obvious lymph node enlargement. After being subjected to splenectomy, the patient was diagnosed with splenic diffuse large B cell lymphoma coexisting with gastrointestinal stromal tumor in the stomach.ConclusionsTo our knowledge, splenic lymphoma accompanied by gastrointestinal stromal tumor in the stomach is rarely reported. This case report discusses the diagnosis and case management of a patient referring to the existing literature.

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Section: Discussionmentioning

confidence: 99%

Simultaneous occurrence of splenic diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report

et al. 2018

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“…The most common presenting symptoms of PSL are fever, malaise, left upper quadrant pain, weight loss and night sweats (14,15). Furthermore, during the early stages of the disease, patients tend to be asymptomatic (16) and physical examination or laboratory tests usually cannot provide specific diagnostic information, which greatly increases the difficulty of diagnosing true PSL. However, imaging studies may provide more useful information for the diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to splenectomy, treatments for PSL include systemic chemotherapy and radiotherapy; however, splenectomy may be preferable, as it provides correct diagnosis and effective treatment (16). Splenectomy followed by combination chemotherapy may achieve excellent long-term survival.…”

Section: Discussionmentioning

confidence: 99%

Fever of unknown origin revealed to be primary splenic lymphoma: A rare case report with review of the literature

Sun

Cheng

Wang

et al. 2016

Molecular and Clinical Oncology

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Abstract. Fever is a common clinical presentation of a number of diseases. A sustained unexplained fever >38.3˚C lasting for >3 weeks without an established diagnosis despite intensive diagnostic evaluation is referred to as fever of unknown origin (FUO). FUO remains a clinical challenge for physicians, as it may be attributed to a wide range of disorders, mainly infections, malignancies, non-infectious inflammatory diseases and miscellaneous diseases. We herein report the case of a 59-year-old male patient who presented with prolonged unexplained fever and was found to have a diffusely enlarged hypermetabolic spleen, as shown on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography examination. Following splenectomy, histopathological examination revealed primary splenic lymphoma (PSL) of B-cell origin. The patient received 6 courses of systemic chemotherapy with rituximab, etoposide, cyclophosphamide, doxorubicin, vincristine and prednisone (R-ECHOP regimen) and responded well to treatment. Thus, in patients with FUO and splenomegaly, the possibility of PSL should be taken into consideration. IntroductionThe term ʻfever of unknown originʼ (FUO) was first introduced by Petersdorf and Beeson in 1961 based on an analysis of 100 cases, and it was defined as recurrent fever >38.3˚C, lasting for >3 weeks, remaining undiagnosed after 1 week of in-hospital evaluation (1). Several decades later, the criteria of FUO diagnosis have changed and it is currently defined by lack of a definitive diagnosis after appropriate inpatient or outpatient evaluation (2). In view of the patient's clinical circumstances and underlying immune status, FUO was categorized into classic, nosocomial, neutropenic and human immunodeffiency virus (HIV)-associated FUO by Durack and Street in 1991 (3). The etiologies of classic FUO mainly include infections, malignancies, non-infectious inflammatory diseases and miscellaneous causes, while some cases remain undiagnosed (4,5).Primary splenic lymphoma (PSL) is a rare malignant lymphoma with an incidence of ~1% among patients with non-Hodgkin lymphoma (NHL) (6), although the spleen is involved in approximately half of the cases of Hodgkin's disease and one-third of NHLs as part of systemic disease (7,8). Dasgupta et al (9) strictly defined PSL as lymphoma originating in the spleen and limited to the spleen and splenic hilum, without invasion of other sites, with an interval of ≥6 months prior to the appearance of lymphoma elsewhere.We herein present the case of a 59-year-old male patient with diffuse large B-cell PSL, who only exhibited sustained fever, without other remarkable complaints. To investigate the cause of the FUO, fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) examination was performed and revealed a diffusely enlarged hypermetabolic spleen. Following diagnostic splenectomy, the histopathological diagnosis was diffuse large B-cell primary splenic NHL. Case reportA 59-year-old male patient presented with a history of fe...

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“…However, PSL is a most common subtype in the primary spleen tumours. PSL as a lymphoma usually involves the spleen and splenic hilar lymph nodes 20,21 . Similar to IMT, PSL tends to be asymptomatic and present as a large mass within the spleen on radiology 22,23 .…”

Section: Discussionmentioning

confidence: 99%

“…PSL as a lymphoma usually involves the spleen and splenic hilar lymph nodes. 20,21 Similar to IMT, PSL tends to be asymptomatic and present as a large mass within the spleen on radiology. 22,23 From a review of the literature, it seems that the initial diagnosis of PSL and IMT are made only occasionally at splenectomy.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory myofibroblastic tumour of the spleen: A case report and literature review

Chen¹,

Wei²,

Guo³

2010

Surgical Practice

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Inflammatory myofibroblastic tumour (IMT) is a benign lesion consisting of myofibroblastic spindle cells with an inflammatory cells infiltration. Their behaviour is generally not aggressive, but in some cases they can simulate malignant neoplasms, from which they are impossible to be distinguished before excision. We report a case of IMT originating from the spleen in a 65‐year‐old woman. She underwent splenectomy with the diagnosis of lymphoma, whereas the final pathological diagnosis was IMT. By referring to previously diagnosed IMT cases in our hospital and relevant literature, we conclude that, as a result of a lack of clinical and imaging features, surgical excision is the primary choice of IMT, in order to obtain a definitive diagnosis as well as to avoid recurrence and metastasis, and the subsequent follow up is necessary.

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Primary Splenic Lymphoma Associated with Hemophagocytic Lymphohistiocytosis Complicated with Splenic Rupture

Cited by 18 publications

References 13 publications

Simultaneous occurrence of splenic diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report

Simultaneous occurrence of splenic diffuse large B cell lymphoma and gastrointestinal stromal tumor in the stomach: a case report

Fever of unknown origin revealed to be primary splenic lymphoma: A rare case report with review of the literature

Inflammatory myofibroblastic tumour of the spleen: A case report and literature review

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