Splenic Cyst Following Abdominal Trauma?
A 73-year-old man attended the emergency department with left upper abdominal pain. He reported blunt trauma 4 weeks earlier, together with deterioration of general health and weight loss. He was referred to the surgical department. Sonography and computed tomography (Figure) demonstrated a giant splenic cyst with displacement of the stomach and pancreas towards the midline and left-sided elevation of the diaphragm. The cyst was suspected to be traumatic in origin. Serologically there was no sign of echinococcosis. After the appropriate vaccinations, the patient underwent open splenectomy en bloc. Surprisingly, histology showed infiltration by a diffuse large-cell B-cell lymphoma (DLBCL), prompting transfer of the patient to the hematological department. The further diagnostic work-up revealed no other signs of lymphoma. The patient received chemotherapy (rituximab/bendamustine) and remains relapse-free 5 years after diagnosis. Primary splenic lymphoma is extremely rare, usually taking the form of DLBCL or splenic marginal zone lymphoma.
Dr. med. Enrico Schalk, Prof. Dr. med. Thomas Fischer, Dr. med. Denise Wolleschak,
Klinik für Hämatologie und Onkologie, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, firstname.lastname@example.org
Conflict of interest statement: The authors declare that no conflict of interest exists
Translated from the original German by David Roseveare.
Cite this as: Schalk E, Fischer T, Wolleschak D: Splenic cyst following abdominal trauma? Dtsch Arztebl Int 2019; 116: 362. DOI: 10.3238/arztebl.2019.0362b