Primary Splenic Lymphoma: Can Trucut Biopsy and R-Chop Supersede Splenectomy?

Abstract

Primary Splenic lymphoma is a rare type of Non Hodgkin’s lymphoma of the spleen with or without splenic hilar lymph nodes with preservation of other organ systems. In this case, we encountered a patient who presented with fever of unknown origin since 25 days and was diagnosed with Primary splenic lymphoma based on a tru cut biopsy which was then confirmed by immunohistochemistry. Patient was treated with Chemotherapy alone and showed no recurrence after 6 months of follow up. The aim of reporting this case is to have a high index of suspicion for rare malignancies like PSL in cases of FUO. Contrary to the current guidelines, use of trucut biopsy can be used as a promising investigation to diagnose PSL and treatment with chemotherapy with R-CHOP regimen alone prevented recurrence of the tumour. Investigations like PET-CT which have 100% accuracy in diagnosing PSL can reduce the number of operative procedures like splenectomy used for its diagnosis and treatment.