Postchemotherapy histiocyte-rich pseudotumor involving the spleen.
We report 2 cases of splenic postchemotherapy histiocyte-rich pseudotumor. Each patient had a history of diffuse large B-cell lymphoma, treated with multiagent chemotherapy. Computed tomography scans performed on both patients showed splenic masses. A positron emission tomography scan performed on 1 patient showed increased metabolic activity. The preoperative diagnosis in both patients was recurrent lymphoma, prompting splenectomy. The splenectomy specimens showed multiple, tan-white, firm nodules, up to 3.5 cm in diameter, that were histologically composed of central necrotic B cells (CD20+/CD3-), consistent with necrotic lymphoma, surrounded by numerous lipid-laden (xanthomatous) histiocytes. Clinical staging studies at the time of splenectomy showed no other sites of disease. We conclude that these histologic and immunophenotypic findings represent chemotherapy-induced tumor necrosis with a florid histiocytic reaction mimicking residual viable lymphoma. Others have used descriptive terminology or the term xanthomatous pseudotumor for these lesions that have been only rarely reported in the spleen previously.
Chandra
Pranil
P
The Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. pranil.chandra@aurora.org
Wen
Yong Hannah
YH
Tuli
Sandeep
S
Raphael
Bruce G
BG
Amorosi
Edward L
EL
Medeiros
L Jeffrey
LJ
Ibrahim
Sherif
S
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015614:Histiocytosis / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009336:Necrosis / Q000473:pathology; D013154:Spleen / Q000187:drug effects* / Q000473:pathology