Postmortem diagnosis of intravascular large B-cell lymphoma after atraumatic splenic rupture due to splenic infiltration
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- KUROKI Wataru
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- KOBAYASHI Takahiro
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- UMAKOSHI Michinobu
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine
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- KITADATE Akihiro
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- IMAIZUMI Chihiro
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- SAITO Masaya
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- KOBAYASHI Isuzu
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- FUJISHIMA Masumi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- FUJISHIMA Naohito
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- YOSHIOKA Tomoko
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
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- GOTO Akiteru
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine
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- TAKAHASHI Naoto
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine
Bibliographic Information
- Other Title
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- 脾臓浸潤による非外傷性脾破裂をきたし剖検で確定診断した血管内大細胞型B細胞リンパ腫
- ヒゾウ シンジュン ニ ヨル ヒガイショウセイヒハレツ オ キタシ ボウケン デ カクテイ シンダン シタ ケッカン ナイ ダイ サイボウガタ Bサイボウ リンパシュ
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Abstract
<p>Atraumatic splenic rupture (ASR) is a rare but fatal complication of malignant lymphoma. However, only one case of intravascular large B-cell lymphoma (IVLBCL)-related ASR (IVLBCL-ASR) has previously been reported, and the mechanism of IVLBCL-ASR is unknown. We present the case of a 78-year-old man who died unexpectedly and was diagnosed with IVLBCL-ASR pathologically by autopsy. A massive intraperitoneal hemorrhage and four lacerations on the splenic surface were discovered during the autopsy. CD20-positive lymphoma cells that infiltrated into small vessels were highly concentrated in the center of the spleen and were only slightly distributed in the lacerations on the splenic surface. Therefore, increased intrasplenic pressure due to lymphoma cell proliferation was identified as the cause of ASR. The patient had undergone 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for tongue cancer evaluation 3 months earlier, and positive uptake was found in the right adrenal gland, where lymphoma cell infiltration was confirmed by the autopsy. Our findings suggest that clinicians should be aware that the advanced stage of IVLBCL can cause fatal ASR via increased intrasplenic pressure. Therefore, early diagnosis and early treatment intervention are desirable to prevent the onset of IVLBCL-ASR, and 18F-FDG PET/CT is useful for the early diagnosis of IVLBCL.</p>
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 63 (6), 523-529, 2022
The Japanese Society of Hematology
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Keywords
Details 詳細情報について
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- CRID
- 1390574181058742400
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- NII Book ID
- AN00252940
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- ISSN
- 18820824
- 04851439
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- NDL BIB ID
- 032255756
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
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- Abstract License Flag
- Disallowed