Primary splenic lymphoma - diffuse large B-cell lymphoma

Case contributed by Yaïr Glick
Diagnosis certain

Presentation

Deterioration in general state, fever, anemia, rise in inflammatory markers and hepatic function tests.

Patient Data

Age: 85 years
Gender: Female

In comparison to previous CT abdomen done almost 2 years previously (see study below):

CT abdomen from almost 2 years prior:

Ultrasound-guided core biopsy obtained from the splenic mass.

Case Discussion

An elderly woman was admitted to the hospital with a febrile illness. CT abdomen showed a large hypodense splenic mass. A previous study from almost 2 years earlier had shown a small splenic mass that had not been investigated further. On the current occasion, a core biopsy was promptly obtained from the mass.

Spleen (core biopsy): diffuse large B-cell lymphoma. Fibrotic core infiltrated by a population of large atypical cells which are positive for CD19, CD20, CD45 (LCA), CD79a, and Bcl6, and negative for CD3, CD5, CD10, CD23, cyclin-D1, and pankeratin. Ki67 index: 70-80%.

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