title: Diagnosis and treatment challenges in a patient with splenic tumor and chronic viral hepatitis.
abstract: Non-Hodgkin lymphoma is a cancer of the lymphatic tissue located in various parts of the body: lymph nodes, spleen, thymus, adenoids, tonsils, and bone marrow. The disease occurs mainly in adults, with a higher incidence within the age range of 45 to 60 years. We present a clinical case of non-Hodgkin lymphoma diagnosed in a patient with chronic viral hepatitis B and D. The particularity of this case consists in the diagnosis of primitive spleen lymphoma, described in less than 1% of the cases, and also the difficult antiviral therapy recommendation for the liver disease, given the associated co-morbidity.
  
  
  BACKGROUND
  NHL = Non-Hodgkin lymphoma, HDV = Hepatitis delta virus, HCV = Hepatitis C virus, HBV = Hepatitis B virus, CT = Computerized tomography, CEUS = Contrast enhanced ultrasonography, CHOP = cyclophosphamide, doxorubicin, vincristine, prednisone, R-CHOP = cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab.
authors.affiliation: Department of Internal Medicine, Emergency County Hospital Craiova, Romania.
authors.forename: S C
authors.initials: SC
authors.lastname: Firulescu
authors.affiliation: Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania.
authors.forename: D L
authors.initials: DL
authors.lastname: Săndulescu
authors.affiliation: Department of Internal Medicine, Emergency County Hospital Craiova, Romania.
authors.forename: Ş C
authors.initials: ŞC
authors.lastname: Dinescu
authors.affiliation: Radiology and Imaging Department, University of Medicine and Pharmacy Craiova, Romania.
authors.forename: I A
authors.initials: IA
authors.lastname: Gheonea
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Dr. Carol Davila" Clinical Hospital of Nephrology, Bucharest, Romania.
authors.forename: R M
authors.initials: RM
authors.lastname: Purcarea
authors.affiliation: Surgery Department, Emergency County Hospital Craiova, Romania.
authors.forename: S M
authors.initials: SM
authors.lastname: Săndulescu
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D005260:Female; D006521:Hepatitis, Chronic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy* / Q000821:virology; D006801:Humans; D013160:Splenic Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014463:Ultrasonography
keywords: contrast enhanced ultrasound; delta hepatitis; non-Hodgkin’s lymphoma; splenic tumor