Diffuse Large B Cell Lymphoma of Spleen: An Important Differential of a Nodular Splenomegaly: A Case Report

Abstract

Diffuse large B cell lymphoma (DLBCL) is the most common histological subtype of non-Hodgkin’s lymphoma. However, splenic DLBCL is a relatively uncommon form of non-Hodgkin’s lymphoma.1 In this case report, the authors present a 38-year-old male who was admitted to the hospital with a complaint of abdominal distension, left-sided abdominal pain, loss of weight, and loss of appetite for 2 months. The basic workup of this patient was suggestive of microcytic anaemia with a raised total lymphocyte count, platelet count, and erythrocyte sedimentation rate, while a nodular spleen with altered splenic echotexture was revealed on ultrasonography. Splenic malignancy was suspected and contrast-enhanced CT of the abdomen was planned, which gave an impression of an extra splenic mass lesion causing impingement on the spleen with continuity to bowel loops and thickening of the fascia, raising the possibility of a gastrointestinal stromal tumour; however, the presence of large conglomerated necrosed lymph nodes in the abdominal cavity pointed the diagnosis towards a splenic lymphoma. The splenectomy specimen had multiple nodular deposits and immunohistochemistry studies finally provided a clear-cut diagnosis of DLBCL–mucosa-associated lymphoid tissue lymphoma.