A case of bone marrow-liver-spleen type diffuse large B-cell lymphoma: importance of rapid diagnosis and therapeutic...

Bone marrow-liver-spleen (BLS)-type diffuse large B-cell lymphoma (DLBCL) is a rare and aggressive variant characterized by primary involvement of the bone marrow, liver, and spleen without lymphadenopathy. We describe the case of a 73-year-old woman who presented with multiorgan failure complicated by disseminated intravascular coagulation and clinical features suggestive of secondary hemophagocytic lymphohistiocytosis. Prompt initiation of intensive chemotherapy (R-CHOP: Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone) guided by characteristic clinical findings including bone marrow smear examination, resulted in rapid clinical improvement and prolonged survival.Rather than representing an unusual diagnostic dilemma, this case illustrates a clinically characteristic and educational presentation of BLS-type DLBCL and highlights the importance of timely lymphoma-directed treatment based on readily available hematologic evidence.