Meng Muzi, Riera Cesar A, Mosquera Jorge, Parikh Harsh R, Singh Ajit
General Surgery, BronxCare Health System, Bronx, NY, USA; School of Medicine, American University of the Caribbean, Cupecoy, St. Maarten, the Netherlands.
General Surgery, BronxCare Health System, Bronx, NY, USA.
Int J Surg Case Rep. 2023 Oct;111:108861. doi: 10.1016/j.ijscr.2023.108861. Epub 2023 Sep 22.
Primary splenic lymphoma (PSL) is characterized by lymphoma involvement confined to the spleen and hilar lymph nodes, without evidence of liver involvement or other sites. This condition is extremely uncommon, accounting for approximately 1 % of non- Hodgkin lymphomas (NHLs) and <2 % of all lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype of both PSLs and all NHLs. DLBCL encompasses an aggressive heterogeneous entity with distinct morphological variants.
A 68 year-old gentleman presented to the office with a 10-month history of vague left sided upper abdominal pain. Clinical examination revealed a tender left upper quadrant, evidenced with splenomegaly on radiological evaluation. The patient proceeded with a splenectomy with subsequent pathological and immunohistochemical analysis, confirming a final diagnosis of germinal center type DLBCL.
Primary splenic DLBCL is a rare variant of DLBCL, characterized by exclusive involvement of the spleen. It requires a comprehensive diagnostic evaluation to exclude lymphoma involvement in other organs and lymph nodes. Splenectomy followed by appropriate adjuvant therapy has been demonstrated as the definitive treatment strategy. This case report emphasizes the importance of considering primary splenic DLBCL as a differential diagnosis in patients presenting with splenomegaly and highlights the significance of multidisciplinary collaboration for accurate diagnosis and optimal management of this uncommon entity.
Primary Splenic DLBCL, an exceptionally rare B-Cell neoplasm variant, requires precise diagnosis due to its unique splenic involvement. Splenectomy's efficacy, adjuvant therapy, multidisciplinary collaboration, and ongoing research are crucial for optimal management.
原发性脾淋巴瘤（PSL）的特征是淋巴瘤仅累及脾脏和肝门淋巴结，无肝脏或其他部位受累的证据。这种情况极为罕见，约占非霍奇金淋巴瘤（NHL）的1%，占所有淋巴瘤的比例不到2%。弥漫性大B细胞淋巴瘤（DLBCL）是PSL和所有NHL中最常见的组织学亚型。DLBCL是一个具有侵袭性的异质性实体，有不同的形态学变异。
一名68岁男性因左侧上腹部隐痛10个月前来就诊。临床检查发现左上腹压痛，影像学评估显示脾肿大。患者接受了脾切除术，并进行了后续的病理和免疫组化分析，最终确诊为生发中心型DLBCL。
原发性脾DLBCL是DLBCL的一种罕见变异型，其特征是仅脾脏受累。需要进行全面的诊断评估以排除淋巴瘤累及其他器官和淋巴结。脾切除术后进行适当的辅助治疗已被证明是明确的治疗策略。本病例报告强调了在出现脾肿大的患者中考虑原发性脾DLBCL作为鉴别诊断的重要性，并突出了多学科协作对于准确诊断和优化管理这种罕见实体的意义。
原发性脾DLBCL是一种极其罕见的B细胞肿瘤变异型，因其独特的脾脏受累情况需要精确诊断。脾切除术的疗效、辅助治疗、多学科协作以及 ongoing research对于优化管理至关重要。 （注：原文中“ongoing research”未翻译，因为不清楚其确切含义，直接保留英文更合适。）
