Page 108 - TD-4-2

Tumor Discovery

CASE REPORT
Diffuse large B-cell lymphoma in the splenic hilar

lymph node mimicking an intrasplenic lesion

1
Naoyuki Anzai , Keisuke Ueda , Yuma Takeuchi , Yusuke Nakayama ,
2
2
2
Yasuhiro Kazuma 1 , Ayaka Fukui , Naoki Nakajima , Yutaka Shimazu 4 , and
3
3
Shinsaku Imashuku *
5
1 Department of Hematology, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
2 Department of Surgery, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
3 Department of Diagnostic Pathology, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
4 Department of Early Clinical Development, Graduate School of Medicine, Kyoto University, Kyoto,
Japan
5 Department of Laboratory Medicine, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan

Abstract

Diffuse large B-cell lymphoma (DLBCL) in the splenic hilar lymph node mimicking
an intrasplenic lesion is considered rare in the literature. This case is discussed as a
form of a primary splenic DLBCL and as a stage I/II abdominal DLBCL. Primary splenic
DLBCL was previously defined as a lymphoma confined to the spleen, with or without
involvement of the hilar lymph node or distant lesions. However, the condition is
not included in the 5 edition of the World Health Organization classification. In this
th
report, we describe the case of a 63-year-old Japanese male who presented with a
*Corresponding author:
18
Shinsaku Imashuku 5 cm F-fluorodeoxyglucose-avid mass identified on imaging, presumed to be an
(shinim95@mbox.kyoto-inet.or.jp) intrasplenic mass. Subsequent splenectomy confirmed that the mass was DLBCL
Citation: Anzai N, Ueda K, originating from the splenic hilar lymph node, distinctly separated from the spleen
Takeuchi Y, et al. Diffuse large and the tail of the pancreas. Postoperatively, the patient responded well to treatment
B-cell lymphoma in the splenic comprising three courses of a combined regimen of polatuzumab vedotin, rituximab,
hilar lymph node mimicking an cyclophosphamide, daunorubicin, and prednisolone. This case underscores the
intrasplenic lesion. Tumor
Discov. 2025;4(2):100-104. importance of caution when diagnosing intrasplenic lesions based on imaging, as
doi: 10.36922/td.6742 the lesions may be located outside the spleen.
Received: November 30, 2024
Revised: January 25, 2025 Keywords: Diffuse large B-cell lymphoma; Splenic hilar lymph node; Non-intrasplenic
Accepted: February 17, 2025 lymphoma; Positron emission tomography-computed tomography
Published online: March 4, 2025
Copyright: © 2025 Author(s).
This is an Open-Access article 1. Introduction
distributed under the terms of the
Creative Commons Attribution Splenic neoplasms encompass various tumors, such as splenic hemangioma,
License, permitting distribution, lymphangioma, various subtypes of lymphomas, and angiosarcoma, which must be
and reproduction in any medium,
th
provided the original work is differentiated for accurate diagnosis and management. In the 5 edition of the World
properly cited. Health Organization classification of splenic B-cell lymphomas and leukemias, diffuse
1
Publisher’s Note: AccScience large B-cell lymphoma (DLBCL) is not listed as a specific subtype. However, although
Publishing remains neutral with rare, primary splenic DLBCL has been documented in several case reports and case
regard to jurisdictional claims in 2-13 2
published maps and institutional series (Table 1). According to Shimizu-Kohno et al., an analysis of 115 specimens
affiliations. of splenic lymphoid neoplasms in Japan revealed that DLBCL was the most common

Volume 4 Issue 2 (2025) 100 doi: 10.36922/td.6742