以原发性脾淋巴瘤为表现的弥漫性大B细胞淋巴瘤1例并文献复习

Diffuse large B-cell lymphoma presenting as primary splenic lymphoma:one case report and literature review

目的:探讨原发性脾淋巴瘤(PSL)的诊断以及原发性脾弥漫性大B细胞淋巴瘤的治疗。方法:报告1例以PSL为表现的弥漫性大B细胞淋巴瘤并结合文献进行复习。结果:患者表现为左上腹疼痛,无发热、盗汗,无浅表淋巴结肿大,CT证实脾脏内有占位性病变,脾脏病理示弥漫性大B细胞淋巴瘤,外周血和骨髓检查正常,脾切除术后PET/CT未见明显与淋巴瘤相关的18F-脱氧葡萄糖摄取异常增高表现,后给予联合化疗,随访8月余仍处于完全缓解期。结论:PSL是一少见肿瘤,采取脾切除后继以CHOP±利妥昔单抗治疗原发性脾弥漫性大B细胞淋巴瘤能够达到长期生存的目的。

Objective：To study the diagnosis of primary splenic lymphoma（PSL）and the treatment of primary diffuse large B-cell lymphoma of spleen.Methods： One case of diffuse large B-cell lymphoma presenting as PSL was reported and the related articles were reviewed.Results： A 26-year-old man presented left upper quadrant pain and absence of fever,night sweats,or lymphadenopathy.He was found to have the mass lesion in the spleen documented by CT scan.A splenectomy was performed which showed diffuse large B-cell lymphoma.Peripheral blood smears and bone marrow aspiration did not reveal any evidence of lymphoma.PET/CT examination showed no abnormalities of 18F-fluorodexyglucose uptake associated with lymphoma after splenectomy.The patient received combined chemotherapy and has been complete remission without relapse for 8 months.Conclusion： PSL is a rare disease.Splenectomy followed by combined chemotherapy such as CHOP±rituximab,results in excellent long-term survival in primary diffuse large B-cell lymphoma of spleen.