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Primary splenic lymphoma.

Mushahid Aslam1, Nuzhat Salamat, Nadra Mamoon

  • 1Department of Surgery, Combined MIlitary Hospital, Multan. nuzhatsalamat@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|April 21, 2006
PubMed
Summary

A middle-aged woman with fever and enlarged spleen was diagnosed with diffuse large B-cell lymphoma after a splenectomy. Surgical removal of the spleen led to complete remission of the lymphoma.

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Splenomegaly and fever are common symptoms that can be indicative of various infectious and neoplastic diseases.
  • Differential diagnosis in endemic areas often includes malaria, typhoid fever, and tuberculosis, complicating initial patient management.
  • The spleen can be a primary site for certain hematologic malignancies, necessitating thorough diagnostic evaluation.

Observation:

  • A middle-aged female patient presented with persistent fever and significant splenomegaly.
  • Initial treatments for malaria, typhoid, and tuberculosis were administered without definitive diagnosis.
  • Diagnostic splenectomy was performed due to persistent, unexplained symptoms and splenomegaly.

Findings:

  • Histopathological examination of the spleen revealed diffuse large B-cell lymphoma, a type of non-Hodgkin lymphoma.
  • The lymphoma was found to be localized exclusively to the spleen.
  • The patient achieved complete remission following the splenectomy.

Implications:

  • Splenectomy can be a curative treatment for localized splenic diffuse large B-cell lymphoma.
  • This case highlights the importance of considering hematologic malignancies in the differential diagnosis of unexplained fever and splenomegaly.
  • Diagnostic splenectomy, while invasive, can provide a definitive diagnosis and therapeutic benefit in select cases of splenic pathology.

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