A 69-year-old woman with fever, abdominal pain, melena, and weight loss was diagnosed with stage IV primary splenic diffuse large B-cell lymphoma via esophagogastroscopy, a rare presentation of non-Hodgkin's lymphoma.
- CT imaging revealed a 100 mm heterogenous splenic mass penetrating the gastric wall, splenomegaly, and multiple lymph nodes up to 30 mm in diameter.
- Esophagogastroscopy showed a large non-bleeding ulcer on the proximal gastric corpus; biopsies confirmed high-grade large B-cell lymphoma with BCL6 translocation.
- Treatment with six cycles of R-CHOP chemotherapy resulted in partial response with persistent splenic disease, followed by radiotherapy.
- Primary splenic diffuse large B-cell lymphoma represents less than 1% of non-Hodgkin's lymphomas and is particularly rare in hepatitis C seronegative immunocompetent patients.
- Esophagogastroscopy enabled histological diagnosis without more invasive procedures, avoiding delays in treatment initiation.
This summary was generated by an AI large language model based on the content transcript. It is for informational
purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional
expertise and the full clinical context when making clinical decisions.