Atypical Presentation of Primary Splenic Diffuse Large B-cell Non-Hodgkin Lymphoma, CD30 Positive: Case Report
DOI:
https://doi.org/10.17533/udea.iatreia.360Abstract
Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma; however, its primary splenic variant (DLBCL-PS) is unusual and can present with atypical clinical manifestations. CD30 expression, which is uncommon in this subtype, has relevant prognostic and therapeutic implications.
Case presentation: A 48-year-old male patient who presented with abdominal pain, fever, and splenomegaly is described. Following an emergency splenectomy due to an abscess with 70% splenic necrosis, histopathological and immunohistochemical analysis revealed CD30-positive DLBCL-PS with a high proliferative index. The patient was referred to hematology-oncology for specialized management.
Discussion: DLBCL-PS represents less than 1% of lymphomas, and its diagnosis is complex when it mimics infectious processes. Splenectomy has diagnostic and therapeutic relevance and is associated with improved survival. CD30 expression defines a subgroup with a better prognosis and potential benefit from targeted therapies such as brentuximab vedotin.
Conclusions: This case illustrates the diagnostic challenge of DLBCL-PS when it presents as a complicated splenic abscess and highlights the importance of considering DLBCL in the differential diagnosis of splenic lesions.
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