Abstract
A 58-yr-old male with a history of hepatitis C virus infection, presented with a 2-mo history of intractable left upper abdominal pain. He had fallen from a ladder 2 yr previously, landing on his left side. Abdominal computed tomography identified a large cystic mass in the spleen. The patient was brought to the operating room with a presumptive diagnosis of symptomatic, post-traumatic, false cyst of the spleen. Instead, at surgery, a splenic mass with dense adhesions to the diaphragm and stomach was found. On final histological analysis, it was diagnosed to be a large B-cell lymphoma. Despite its rarity, gastroenterologists and surgeons should be aware of large B-cell lymphoma when encountering cystic lesions of the spleen, because the management of benign cystic disease is usually nonsurgical.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gobbi PG, Grignani GE, Pozzetti U, et al. Primary splenic lymphoma: does it exist? Haematologica 1994; 79: 286–293.
Isaacson PG. Splenic marginal zone lymphoma. Blood 1996; 88: 751–752.
Hoffman E, Chang YW. Nonparasitic splenic cysts. Md Med J 1990; 39: 671–674.
Faer MJ, Lynch RD, Lichtenstein JE, Madewell JE, Feigin DS. Traumatic splenic cyst: radiologic-pathologic correlation from the Armed Forces Institute of Pathology. Radiology 1980; 134: 371–376.
Ota T, Kusaka S, Mizuno M. A splenic pseudotumor: an accessory spleen. Ann Nucl Med 2003; 17: 159–160.
Arber DA, Rappaport H, Weiss LM. Non-Hodgkin’s lymphoproliferative disorders involving the spleen. Mod Pathol 1997; 10: 18–32.
Pittaluga S, Verhoef G, Criel A, et al. “Small” B-cell non-Hodgkin’s lymphomas with splenomegaly at presentation are either mantle cell lymphoma or marginal zone cell lymphoma. A study based on histology, cytology, immunohistochemistry, and cytogenetic analysis. Am J Surg Pathol 1996; 20: 211–223.
Mollejo M, Algara P, Mateo MS, et al. Large B-cell lymphoma presenting in the spleen: identification of different clinicopathologic conditions. Am J Surg Pathol 2003; 27: 895–902.
Harris NL, Aisenberg AC, Meyer JE, Ellman L, Elman A. Diffuse large cell (histocytic) lymphoma of the spleen. Clinical and pathologic characteristics of ten cases. Cancer 1984; 54: 2460–2467.
Urrutia M, Mergo PJ, Ros LH, Torres GM, Ros PR. Cystic masses of the spleen: radiologic-pathologic correlation. Radiographics 1996; 16: 107–129.
Kawashima A, Urban BA, Fishman EK. Malignant lesions of the spleen, in: Textbook of Gastrointestinal Radiology; Gore RM, Levine MS, eds. Sanders, Philadelphia, PA, 2000.
Satoh T, Yamada T, Nakano S, et al. The relationship between primary splenic malignantlymphoma and chronic liver disease associated with hepatitis C virus infection. Cancer 1997; 80: 1981–1988.
Izumi T, Sasaki R, Miura Y, Okamoto H. B cell malignancy and hepatitis C virus infection. Leuk Res 1996; 20: 445.
Naschitz JE, Zuckerman E, Elias N, Yeshurun D. Primary hepatosplenic lymphoma of the B-cell variety in a patient with hepatitis C liver cirrhosis. Am J Gastroenterol 1994; 89: 1915–1916.
Ferri C, La Civita L, Monti M, et al. Chronic hepatitis C and B-cell non-Hodgkin’s lymphoma. QJM 1996; 89: 117–122.
Franzin F, Efremov DG, Pozzato G, Tulissi P, Batista F, Burrone OR. Clonal B-cell expansions in peripheral blood of HCV-infected patients. Br J Haematol 1995; 90: 548–552.
Morsica G, Tambussi G, Sitia G, et al. Replication of hepatitis C virus in B lymphocytes (CD19+). Blood 1999; 94: 1138–1139.
Falk S, Stutte HJ. Primary malignant lymphomas of the spleen. A morphologic and immunohistochemical analysis of 17 cases. Cancer 1990; 66: 2612–2619.
Brox A, Shustik C. Non-Hodgkin’s lymphoma of the spleen. Leuk Lymphoma 1993; 11: 165–171.
Ahmann DL, Kiely JM, Harrison EG, Jr, Payne WS. Malignant lymphoma of the spleen. A review of 49 cases in which the diagnosis was made at splenectomy. Cancer 1966; 19: 461–469.
Haj M, Zaina A, Wiess M, et al. Pathologic-spontaneousrupture of the spleen as a presenting sign of splenic T-cell lymphoma—case report with review. Hepatogastroenterology 1999; 46: 193–195.
Schiodt I, Duun E, Fischer TK, Christiansen AP, Ralfkiaer E. Fatal rupture of the spleen caused by infiltration of T-cell lymphoma. Ann Hematol 2000; 79: 158–160.
Hebeda KM, MacKenzie MA, van Krieken JH. A case of anaplastic lymphoma kinase-positive anaplastic large cell lymphoma presenting with spontaneous splenic rupture: an extremely unusual presentation. Virchows Arch 2000; 437: 459–464.
Skarin AT, Davey FR, Moloney WC. Lymphosarcoma of the spleen. Results of diagnostic splenectomy in 11 patients. Arch Intern Med 1971; 127: 259–265.
Mulligan SP, Matutes E, Dearden C, Catovsky D. Splenic lymphoma with villous lymphocytes: natural history and response to therapy in 50 cases. Br J Haematol 1991; 78: 206–209.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Takabe, K., Al-Refaie, W., Chin, B. et al. Can large B-cell lymphoma mimic cystic lesions of the spleen?. Int J Gastrointest Canc 35, 83–88 (2005). https://doi.org/10.1385/IJGC:35:1:083
Issue Date:
DOI: https://doi.org/10.1385/IJGC:35:1:083