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Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Lymphoma | Case report

Primary splenic anaplastic variant of diffuse large B-cell lymphoma: a case report 

Authors: Sawsan Ismail, Filip Ali, Hussein Ajamieh, Samir Kanaan, Rana Issa, Ali Daoud, Zuheir Alshehabi

Published in: Journal of Medical Case Reports | Issue 1/2021

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Abstract

Background

Primary splenic lymphoma represents a rare entity that constitutes less than 1% of non-Hodgkin lymphomas, and less than 2% of all lymphomas. Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype of primary splenic lymphomas. DLBCL encompasses a heterogeneous entity with distinct morphological variants. The anaplastic variant of DLBCL was first defined in the 2017 World Health Organization classification as a rare histological subtype that constitutes less than 3.4% of DLBCL cases.

Case presentation

A 65-year-old Syrian man presented to our hospital with constant dull localized left upper quadrant abdominal pain for about 20 days accompanied by general weakness, loss of appetite, and rapid weight loss. Clinical examination revealed isolated splenomegaly and left upper abdominal tenderness. Following physical, laboratory, and radiologic examinations, the patient underwent splenectomy. Interestingly, pathological and immunohistochemical examinations of the resected spleen confirmed the diagnosis of a primary anaplastic variant of DLBCL.

Conclusions

Herein, we aimed to present an unusual combination of a rare splenic neoplasm and a unique lymphoma subtype. Furthermore, we aimed to highlight the difficulties in differential diagnosis and the importance of histological and immunohistochemical examinations with clinical correlation.
Literature
2.
go back to reference Dasgupta T, Coombes B, Brasfield RD. Primary malignant neoplasms of the spleen. Surg Gynecol Obstet. 1965;120:947–60.PubMed Dasgupta T, Coombes B, Brasfield RD. Primary malignant neoplasms of the spleen. Surg Gynecol Obstet. 1965;120:947–60.PubMed
9.
go back to reference Ahmann DL, Kiely JM, Harrison EG, et al. Malignant lymphoma of the spleen. A review of 49 cases in which the diagnosis was made at splenectomy. Cancer. 1966;19(4):461–9.CrossRef Ahmann DL, Kiely JM, Harrison EG, et al. Malignant lymphoma of the spleen. A review of 49 cases in which the diagnosis was made at splenectomy. Cancer. 1966;19(4):461–9.CrossRef
10.
go back to reference Magomedova AU, Kravchenko SK, Kremenetskaia AM, et al. Primary diffuse large B-cell lymphosarcoma of the spleen. Ter Arkh. 2007;79(7):62–6.PubMed Magomedova AU, Kravchenko SK, Kremenetskaia AM, et al. Primary diffuse large B-cell lymphosarcoma of the spleen. Ter Arkh. 2007;79(7):62–6.PubMed
11.
go back to reference Spier CM, Kjeldsberg CR, Eyre HJ, et al. Malignant lymphoma with primary presentation in the spleen. A study of 20 patients. Arch Pathol Lab Med. 1985;109:1076–80.PubMed Spier CM, Kjeldsberg CR, Eyre HJ, et al. Malignant lymphoma with primary presentation in the spleen. A study of 20 patients. Arch Pathol Lab Med. 1985;109:1076–80.PubMed
12.
go back to reference Bairey O, Shvidel L, Perry C, et al. Characteristics of primary splenic diffuse large B-cell lymphoma and role of splenectomy in improving survival. Cancer. 2015;121:2909–16.CrossRef Bairey O, Shvidel L, Perry C, et al. Characteristics of primary splenic diffuse large B-cell lymphoma and role of splenectomy in improving survival. Cancer. 2015;121:2909–16.CrossRef
13.
go back to reference Campo E, Swerdlow SH, Harris NL, et al. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117(19):5019–32.CrossRef Campo E, Swerdlow SH, Harris NL, et al. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117(19):5019–32.CrossRef
14.
go back to reference Diebold J, Anderson JR, Armitage JO, et al. Diffuse large B-cell lymphoma: a clinicopathologic analysis of 444 cases classified according to the updated Kiel classification. Leuk Lymphoma. 2002;43:97–104.CrossRef Diebold J, Anderson JR, Armitage JO, et al. Diffuse large B-cell lymphoma: a clinicopathologic analysis of 444 cases classified according to the updated Kiel classification. Leuk Lymphoma. 2002;43:97–104.CrossRef
15.
go back to reference Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2017. Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2017.
16.
go back to reference Sakakibara A, Kohno K, Kuroda N, et al. Anaplastic variant of diffuse large B-cell lymphoma with hallmark cell appearance: two cases highlighting a broad diversity in the diagnostics. Pathol Int. 2018;68:251–5.CrossRef Sakakibara A, Kohno K, Kuroda N, et al. Anaplastic variant of diffuse large B-cell lymphoma with hallmark cell appearance: two cases highlighting a broad diversity in the diagnostics. Pathol Int. 2018;68:251–5.CrossRef
17.
go back to reference Haralambieva E, Pulford KA, Lamant L, et al. Anaplastic large cell lymphomas of B-cell phenotype are anaplastic lymphoma kinase (ALK) negative and belong to the spectrum of diffuse large B-cell lymphomas. Br J Haematol. 2000;109:584–91.CrossRef Haralambieva E, Pulford KA, Lamant L, et al. Anaplastic large cell lymphomas of B-cell phenotype are anaplastic lymphoma kinase (ALK) negative and belong to the spectrum of diffuse large B-cell lymphomas. Br J Haematol. 2000;109:584–91.CrossRef
19.
go back to reference Medeiros LJ, Elenitoba JK. Anaplastic large cell lymphoma. Am Soc Clin Pathol. 2007;127:707–22.CrossRef Medeiros LJ, Elenitoba JK. Anaplastic large cell lymphoma. Am Soc Clin Pathol. 2007;127:707–22.CrossRef
21.
go back to reference Li M, Liu Y, Wang Y, et al. Anaplastic variant of diffuse large b cell lymphoma displays intricate genetic alterations and distinct biological features. Am J Surg Pathol. 2017;41:1322–32.CrossRef Li M, Liu Y, Wang Y, et al. Anaplastic variant of diffuse large b cell lymphoma displays intricate genetic alterations and distinct biological features. Am J Surg Pathol. 2017;41:1322–32.CrossRef
22.
go back to reference Lehne G, Hannisdal E, Langholm R, et al. A 10-year experience with splenectomy in patients with malignant non-Hodgkin’s lymphoma at the Norwegian Radium Hospital. Cancer. 1994;74:933–9.CrossRef Lehne G, Hannisdal E, Langholm R, et al. A 10-year experience with splenectomy in patients with malignant non-Hodgkin’s lymphoma at the Norwegian Radium Hospital. Cancer. 1994;74:933–9.CrossRef
Metadata
Title
Primary splenic anaplastic variant of diffuse large B-cell lymphoma: a case report 
Authors
Sawsan Ismail
Filip Ali
Hussein Ajamieh
Samir Kanaan
Rana Issa
Ali Daoud
Zuheir Alshehabi
Publication date
01-12-2021

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