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Arch Surg. 2009;144(7):692.

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Answer: Primary Splenic High-Grade Lymphoma

Primary splenic lymphoma is rare, representing less than 2% of all lymphomas.¹ However, B-cell lymphomas are seen with increasing frequency in patients with chronic hepatitis C. This patient was known to have a splenic mass that was being followed up with serial CT scans because the working diagnosis at the time was a hepatoma metastatic to the spleen. Recently, the mass increased in size and the patient underwent a splenectomy. The patient also had a corresponding rise in his -fetoprotein level. After the splenectomy, the -fetoprotein level decreased significantly. However, it did not return to the normal range.

Several epidemiologic studies suggest that hepatitis C virus may be involved in the pathogenesis of B-cell lymphomas.² These may range from low-grade to high-grade non-Hodgkin's lymphomas. This patient had a known mass in his spleen that suddenly increased in size. Therefore, it is possible that he had a low-grade, marginal-zone lymphoma that . . . [Full Text of this Article]

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Arch Surg. 2009;144(7):691.
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