title: [A Case of Malignant Lymphoma of the Spleen Infiltrating the Diaphragm Treated with Splenectomy].
abstract: A 67-year-old man was treated for diabetes mellitus by his family doctor. A splenic tumor was suspected based on his pain in the left side of the abdomen. He was admitted to our hospital for close inspection and medical treatment. Abdominal CT and MRI scans showed a tumor, 10 cm in diameter, in the spleen. An opaque boundary with the diaphragm was also observed. On PET-CT, accumulations of FDG were observed in the left supraclavicular fossa and the left axilla. The serum levels of LDH and sIL-2R were elevated, and therefore a diagnosis of malignant lymphoma was suspected. Due to the risk of splenic rupture, a splenectomy was performed. After pathological examination, the patient was diagnosed with diffuse large B-cell malignant lymphoma. He is currently being treated with chemotherapy at another medical institute. Splenic rupture occurs in some cases of splenic malignant lymphoma, although the number of reported cases is low. In some of the cases, splenic rupture occurred during treatment of the malignant lymphoma. There is no specific way to measure the risk of splenic rupture; however, performing a prophylactic splenectomy is one option in cases where tumor cells have extended to the capsula lienis, similar to that in our patient.
authors.affiliation: Dept. of Surgery, Takaoka City Hospital.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Terakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Tokoro
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeshita
authors.forename: Naoki
authors.initials: N
authors.lastname: Horikawa
authors.forename: Koji
authors.initials: K
authors.lastname: Ohzawa
authors.forename: Kumi
authors.initials: K
authors.lastname: Ozaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Noboru
authors.initials: N
authors.lastname: Terayama
authors.forename: Eikichi
authors.initials: E
authors.lastname: Okada
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yabushita
mesh_terms: D000368:Aged; D003964:Diaphragm / Q000473:pathology; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D009361:Neoplasm Invasiveness; D012422:Rupture, Spontaneous / Q000517:prevention & control; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome