Rapid response of intrasplenic lesions to steroids in non-Hodgkin's lymphoma

A 70 year old woman had a [99mTc]sulfur colloid liver/spleen scan that showed splenomegaly and multiple intrasplenic defects. The lesions failed to concentrate radiogallium. Thirteen days later, after being on steroid therapy, the spleen had decreased in size and the lesions were only barely apparent. The intrasplenic process, due to non-Hodgkin's lymphoma, was thus markedly sensitive to steroids. It is uncertain if such rapid regression can be employed as a prognostic indicator in non-Hodgkin's lymphoma and suggests the need for further monitoring. The differential diagnosis of the rapid response of intrasplenic lesions to steroids is a limited one, and likely includes sarcoidosis.