The online version of this article (doi:10.1186/1477-7819-10-150) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
YCL participated in drafting the manuscript and in treating the patients. HCC participated in reading the images. WLH participated in treating the patients. SBC participated in treating the patients. RCW participated in pathology review. CJT (corresponding author) participated in drafting the manuscript and in treating the patients. All authors read and approved the final manuscript.
Primary splenic diffuse large B-cell lymphoma (DLBCL) is a rare clinical condition, which is generally treated by six to eight cycles of chemotherapy involving a combination of rituximab and the cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP) regimen. However, the treatment for chemorefractory primary splenic DLBCL remains controversial. Therapeutic splenic irradiation (SI) might be a reasonable and possibly the only treatment option with curative intention for patients with chemorefractory primary splenic DLBCL. However, the efficacy and safety of therapeutic SI are unclear. Herein, we present the case of a primary splenic DLBCL patient who was refractory to multiple chemotherapy regimens but achieved complete remission after administration of therapeutic SI. However, his condition was complicated with severe gastric variceal bleeding due to splenic venous thrombosis, which was successfully treated via splenectomy and short gastric vein ligation. On the basis of our findings, we concluded that the splenic venous thrombosis-induced gastric variceal bleeding was a rare but life-threatening adverse effect of the therapeutic SI administered for primary splenic DLBCL. Surgical intervention involving splenectomy and short gastric vein ligation is mandatory and should be performed as soon as possible for such patients.
Pfreundschuh M, Trumper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M, MabThera International Trial Group: CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006, 7: 379-391. 10.1016/S1470-2045(06)70664-7. CrossRefPubMed
Tanaka M, Tsunoda S, Inoue K, Izumi T, Yamamoto T, Hoshi S, Hirabayashi K, Igarashi S, Akutsu M, Kano Y: Clinical analysis of 3 cases with primary splenic diffuse large B-cell lymphoma (Rinsho ketsueki). Rinsho Ketsueki. 2011, 52: 703-707. PubMed
A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Eng J Med. 1993, 329: 987-994.
Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Castaigne S, Lefort S, Marit G, Macro M, Sebban C, Belhadj K, Bordessoule D, Fermé C, Tilly H: Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d’Etudes des Lymphomes de l’Adulte. Blood. 2010, 116: 2040-2045. 10.1182/blood-2010-03-276246. PubMedCentralCrossRefPubMed
Park LC, Woo SY, Kim S, Jeon H, Ko YH, Kim SJ, Kim WS: Incidence, risk factors and clinical features of venous thromboembolism in newly diagnosed lymphoma patients: results from a prospective cohort study with Asian population. Thromb Res. 2012, Epub ahead of print
- Splenic irradiation-induced gastric variceal bleeding in a primary splenic diffuse large B-cell lymphoma patient: a rare complication successfully treated by splenectomy with short gastric vein ligation
Chieh-Lin Jerry Teng
- BioMed Central
Neu im Fachgebiet Chirurgie
Mail Icon II