title: Primary follicular lymphoma of the spleen incidentally found in a patient with alcohol- and hepatitis C-related liver cirrhosis.
abstract: Primary splenic lymphoma is rare as non-Hodgkin lymphomas. Splenic infiltration of lymphoma cells may cause splenomegaly in many cases. However, splenomegaly is caused not only by tumor involvement but also by non-tumorous disorders. One of the most prevalent non-neoplastic causes is portal hypertension mostly due to liver cirrhosis. On the other hand, liver cirrhosis may underlie various extrahepatic manifestations including development of B-cell non-Hodgkin lymphomas. Here, we report a case of primary follicular lymphoma of the spleen in a patient with liver cirrhosis related to hepatitis C and alcohol. The lymphoma was incidentally found in an enlarged spleen resected palliatively to alleviate symptomatic pancytopenia of the patient. The main characteristic of our case is an incidental finding of a rare situation brought by careful pathological examination. Our case illustrates the importance to recognize a possibility of co-occurrence of chronic liver disease and extrahepatic lymphoma.
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Matsuda
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Okada
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Tazuko
authors.initials: T
authors.lastname: Tokugawa
authors.affiliation: Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine Nishinomiya, Hyogo, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D033162:Incidental Findings; D008103:Liver Cirrhosis / Q000150:complications*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008113:Liver Neoplasms / Q000473:pathology; D008224:Lymphoma, Follicular / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D010198:Pancytopenia / Q000209:etiology / Q000601:surgery; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000150:complications / Q000473:pathology*
keywords: Follicular lymphoma; alcohol; hepatitis C; liver cirrhosis; spleen