Primary Splenic Malignant Lymphoma, Histiocytic Type, With Sclerosis
monthstanaro, A., & Patton, R. (1976). Primary splenic malignant lymphoma, histiocytic type, with sclerosis: report of a case with long-term survival. Cancer, 38(4), 1625–1628. https://doi.org/10.1002/1097-0142(197610)38:4<1625::aid-cncr2820380430>3.0.co;2-x
View Original Source →Abstract
A 61-year-old woman with malignant lymphoma, histiocytic type, with slerosis (sclerosing reticulum cell sarcoma) primary in the spleen is described. She has survived clinically free of malignant lymphoma for 11 years after splenectomy therapy alone. This may be the first case of primary splenic malignant lymphoma, histiocytic type, with sclerosis, ever reported in the medical literature.
Case Details
Disease Location
Spleen
Personal Characteristics
61 -year-old female caucasian
Clinical Characteristics
Hospitalized on april 24, 1964 because of sensation of a mass in her abdomen of 3 weeks duration, she reported no pain or discomfort physical exam revealed a firm, mobile, nontender mass in the left upper quadrant of the abdomen, extending 3 fingerbreadths below the costal margin upper gi and barium enema radiographs showed a large, intraperitoneal, epigastric mass that depressed the splenic flexure of the colon bone marrow exam showed normoblastic erythropoisesis and adequate iron stores lab data on admission were: hematocrit 39%, hemoglobin 12.8g/100ml, platelets 179,000/mm^3, and corrected reticulocyte count 1.3% exploratory laparotomy on the fifth hospital day revealed a markedly enlarged spleen that was loosely adherent to the diaphragm and to the lateral abdominal wall by fibrous adhesions splenectomy and appendectomy were performed on gross exam, the spleen was markedly enlarged, bosselated, and hemorrhagic, measuring 23x12x8cm and weighing 1240grams. Multiple nodular masses, ranging from approx. 5mm to 5cm in diameter extended through the hemorrhagic capsule on cut surface, the splenic parenchyma was almost totally replaced by grey-to-yellow irregular nodules, separated by thin, fibrous cords. Central areas of nodular necrosis were evident, then rims of normal splenic parenchyma were found microscopic sections revealed a cellular neoplasm, individual cells ranged from 20-30um in diameter with a polygonal outline and considerable amphophilic cytoplasm the cell nuclei were oval, large, and vesicular and often contained one or two large nucleoli phagocytotic activity by the tumor cells was evident, collagenous sclerosis of tumor stroma and reticulum deposition were prominent, scattered areas of necrosis were noted these findings were suggestive of malignant lymphoma, histocytic type, with sclerosis
Remission Characteristics
Postop recovery was uneventful and the patient was discharged on may 10, 1964 with no further surgery or therapy the patient was last seen in december 1974 (~11 years later) for a biopsy of a right breast mass (fibrocystic diseases), she currently has no clinical evidence of malignancy
Treatment & Mechanisms
Proposed Remission Mechanisms
Removal of the spleen
Clinical Treatment
Splenectomy and appendectomy
Non-Clinical Treatment
None reported