2 research outputs found
Primary splenic diffuse large Bâcell lymphoma presenting as a splenic abscess
Abstract Diffuse large Bâcell lymphoma (DLBCL) arising in the spleen, also known as primary splenic DLBCL (PSâDLBCL), is a rare form of malignant lymphoma. It is defined as a lymphoma confined to the spleen or involving splenic hilar lymph nodes. Here we report a case of PSâDLBCL with CD30. The patient was a 62âyearâold who presented with 2 weeks of left flank pain, chills, and abdominal distension. Computed tomography identified an 8âcm splenic mass with central necrosis interpreted as an abscess. A drain was placed, yielding purulent necrotic material; cytologically, only neutrophils were identified. However, purulent drainage continued for 28 days without resolution, prompting splenectomy. Pathological dissection revealed a multinodular mass with central necrosis. Microscopic examination revealed extensive karyorrhexis, abundant ghosts of large cells, and scattered large cells with pleomorphic, multilobated, and vesicular nuclei with moderately abundant cytoplasm. Immunohistochemical staining revealed large, atypical cells positive for CD20, CD30, CD45, PAX5, MYC (>40%), MUM1 (>30%), and p53 (focally). The large cells were negative for CD3 (polyclonal), CD4, CD5, CD8, CD10, CD15, CD34, BCL2, BCL6, AE1/AE3, S100, HHV8, and ALK. The Kiâ67 proliferation rate was approximately 80% in large cells. Notably, this PSâDLBCL was positive for CD30, an unusual finding among nonâHodgkin Bâcell lymphomas, which, coupled with the ReedâSternbergâlike morphology, raised the possibility of classic Hodgkin lymphoma. Therefore, we reviewed the literature to confirm the unique features of this large Bâcell lymphoma, its abscessâlike appearance, and its expression of CD30