Non-Hodgkin's lymphoma masquerading as splenic abscess: A case report

Khan, Qaisar Ali; Mumtaz, Arif; Baqi, Abdul; Ain, Hoor Ul; Mahfooz, Rabia Salman; Asim, Nowshad; Iram, Sumaira; Ahmed, Khabab Abbasher Hussien Mohamed; Tahir, Muhammad Junaid; Yousaf, Zohaib

doi:10.1016/j.amsu.2022.104449

Cited by 1 publication

(4 citation statements)

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“…Splenic NHL and abscess both present with B symptoms, including fever, sweating, weight loss, and left upper quadrant pain. Weight loss is more prominent in splenic NHL and chronic splenic abscesses, whereas weight loss is rare in acute abscesses [ 3 , 7 , 8 ]. Lymphadenopathy, a classical sign of NHL, can provide physicians with a clearer understanding of the spread of NHL in patients.…”

Section: Reviewmentioning

confidence: 99%

“…NHL manifests as small, hypoechogenic, circumscribed nodules on ultrasound [ 13 ]. A hypodense lesion adorned with smooth borders and a necrotic center is commonly observed in splenic NHL, often warranting splenectomy to confirm the diagnosis [ 7 ]. Radiological assessment is important but can be non-conclusive, especially if tumor necrosis is present.…”

Section: Reviewmentioning

confidence: 99%

“…As the symptoms and supporting investigations of splenic NHL may be similar to those seen in splenic abscesses, it can be challenging for a physician to differentiate between the two conditions [ 14 ]. Splenic NHL can mask the splenic abscess and lead to misdiagnosis of the pathology [ 3 , 7 , 15 - 17 ]. Therefore, it is crucial to understand the subtypes of splenic NHL, their associated infections, and their management.…”

Section: Reviewmentioning

confidence: 99%

“…With the ever-growing archive of case reports and emerging literature, physicians have been able to better differentiate NHL from splenic abscesses. In recent literature, physicians were able to perform splenectomies followed by histopathological examinations to make accurate diagnoses as the patients did not respond to the antibiotic’s treatment [ 7 , 15 - 17 ]. In addition, in cases where transformations are suspected, such as those seen in nodular lesions with augmented fluorodeoxyglucose uptake, there are clear indications that splenectomy is necessary [ 18 ].…”

Section: Reviewmentioning

confidence: 99%

See 3 more Smart Citations

The Diagnostic Dilemma of Splenic Non-Hodgkin’s Lymphoma and Splenic Abscess: A Narrative Review

Khan¹,

Aisha²,

Farkouh³

et al. 2022

Cureus

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Non-Hodgkin's lymphoma (NHL) is a lymphoproliferative disorder that principally displays lymph node involvement but can also spread to extranodal sites such as the spleen. Primary splenic NHL arises in the spleen and, due to its atypical presentation, can sometimes present similarly to other splenic conditions. This review aims to highlight how primary splenic NHL can be effectively differentiated from other splenic conditions, such as splenic abscesses. PubMed, MEDLINE, Scopus, Google, and Google Scholar were used to identify articles mainly focused on splenic non-Hodgkin's lymphoma and splenic abscess. The search was limited to articles published from January 2005 to November 2022. Of the 229 total articles amassed, only 34 were selected and narratively reviewed. From a thorough review of the current literature, it is evident that splenic NHL displays a similar clinical picture to other splenic conditions, namely splenic abscesses. One cannot easily differentiate between the two conditions, both clinically and via diagnostic imaging. Lymphadenopathy, a hallmark sign of nodal NHL, may or may not be present in splenic NHL. Ultimately, splenectomy with biopsy and immunohistochemical staining (IHC) may be required to confirm the diagnosis. In cases of suspected splenic NHL or splenic abscess with little-to-no symptomatic improvement after medication administration, splenectomy followed by histopathological examination may be required for a definitive diagnosis and proper treatment.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%