A CASE OF PRIMARY MALIGNANT LYMPHOMA OF THE SPLEEN DETECTED DURING CLOSE INSPECTION FOR FEVER OF UNKNOWN ORIGIN

Abstract

We report an operated case of primary malignant lymphoma of the spleen which was detected during close inspection for fever of unknown origin. A 68-year-old woman who had a fever of unknown origin lasting for about one month with recent one-week high fever (38°C) and associated abdominal pain was referred to the hospital. Abdominal CT and ultrasonogram revealed a splenic tumor. Splenectomy with regional lymphnodes dissection was performed. Histological diagnosis was malignant lymphoma, diffuse medium-sized cell type of the spleen and lymphnode. Adjuvant chemotherapy with CHOP was added and the patient was discharged from the hospital. One year later, malignant lymphoma recurred in the right axillary lymph node, that was successfully managed by CHOP therapy and a local excision. Although primary malignant tumors of the spleen are extremely rare, the patient with the disease has a poor prognosis. It is thought that tumorous lesion of the spleen would demand aggressive surgical therapy and adjuvant chemotherapy.