Primary Splenic Lymphoma, a Rare yet Possible Diagnosis: A Case Report and Review of the Literature

The spleen is subject to a variety of benign and malignant disorders, which can be manifested by nonspecific symptoms or signs. Hence, the diagnosis is often made based on radiological examinations and histopathological studies.

Herein we present a case report of a patient with pathologically approved primary splenic lymphoma (PSL). The patient was a 63-year-old woman presented with abdominal pain, predominantly in the left upper quadrant, since 1 month. Complete blood count (CBC) was normal except for mild anemia. Liver enzyme studies showed an elevated alkaline phosphatase level. Ultrasound (US) depicted a huge hypoechoic splenic mass and computed tomography (CT) confirmed the lesion to be a hypodense mass partially exophytic from the superior aspect of the spleen measuring up to 124 mm in size. The patient underwent a midline laparotomy and splenectomy and the spleen was sent for histopathological examination, which revealed high-grade B-cell lymphoma measuring 17 × 16 × 10 cm in size with capsular invasion and without any lymphovascular invasion.

This case report highlights the importance of considering splenic lymphoma as a differential diagnosis, although rare, in a patient with abdominal pain and nonspecific clinical findings