Presenting a case of primary splenic diffuse large B-cell lymphoma

Primary splenic lymphoma approximately comprises 2% of all Non-Hodgkin’s lymphomas. Diffuse large B cell lymphoma, a rare disease, is responsible for 33% of primary splenic lymphomas. In this study a case of primary splenic diffuse large B-cell lymphoma is reported.
Case Report: The case is a 57 years old woman admitted because of weakness‚ malaise‚ abdominal fullness‚ early satiety and weight loss and no lymphadenopathy. Except for huge splenomegaly, no significant finding was found on her physical examination.
No positive finding was found for infections and inflammatory diseases in virology and serology tests. Bone marrow aspiration and biopsy were hypercellular. Except for huge spelenomegaly, central lymphadenopathy was not seen in chest and abdominopelvic CT. The patient had anemia‚ elevated ESR‚ CRP‚ and LDH.
Based on findings, a diagnostic-therapeutic splenectomy was planed. Pathology tests reported a non-hodgkin’s diffuse large B cell lymphoma with a positive CD20 in mmunohistochemistry. Following spelenectomy the patient received chemotherapy (R- CHOP) regimen.
In classical approach to splenomegaly, after ruling out any common causes‚ primary splenic lymphoma must be kept in mind. Splenectomy in these patients is considered not only as a diagnostic‚ but also a therapeutic attempt.