Dalaðýn Primer Nonhodgkin Lenfomasý: Olgu Sunumu

Dalakta en sýk “B cell” fenotipik özellikler gösteren “low grade” malign lenfoma görülür. “Small lymphocytic” lenfoma, “low grade” malign lenfomalar arasýnda en sýk görülen alt gruptur. Dalaðýn malign lenfomalarýnda asemptomatik splenomegali ve hipersplenizm tablosu görülür. “Low grade” splenik “small cell” lenfoma makroskopik olarak organýn her tarafýna daðýlan birkaç milimetre çapýnda multipl nodüllerle karakterizedir. Yetmiþ bir yaþýndaki kadýn hasta, 3 aydýr sol üst kadranda aðrý ve distansiyon þikayeti ile kliniðe baþvurmuþtur. Batýn bilgisayarlý tomografisinde dalak boyutlarýnda artýþ ve orta posterolateralde periferik yerleþimli hipodens bir alan görülmüþtür. Toraks bilgisayarlý tomografisinde ise mediastinal ve hiler patolojik boyutta lenf nodu saptanmamýþtýr. Kemik iliði biyopsisinde hafif retiküler lif artýþý, inter ve paratrabeküler lenfoid nodüller içeren hafif hiperselüler kemik iliði bulgularýna rastlanmýþtýr. Klinik olarak kronik lenfoproliferatif hastalýk ya da splenik lenfoma düþünülen hastaya taný ve tedavi amacýyla splenektomi uygulanmýþtýr. Dalaðýn histopatolojik incelenmesinde “small lymphocytic” tip malign lenfoma tanýmlanmýþtýr. Olgu nadir görülmesi nedeniyle literatür bilgileri ýþýðýnda sunulmuþtur.

Primary Nonhodgkin’s Lymphoma Of The Spleen: Case Report

The most common malignant lymphoma of the spleen is of low grade type, showing the phenotypic features of B cells. Small lymphocytic lymphoma is the most common primary lymphoma of the spleen. Splenic involvement by malignant lymphoma may present as an asymptomatic splenomegaly or result in a picture of hypersplenism. Low grade splenic small lymphocytic lymphoma usually presents grossly as multiple nodules measuring a few milimeters in diameter scattered throughout the organ. Seventy one years old female patient who had pain in the left upper quadrant and abdominal distention is admitted to the hospital. Splenomegaly and peripheral hypodense zone in the middle posterolateral aspect of spleen is found in the abdominal computarized tomography (CT). In the thorax CT, mediastinal and hilar lymphadenopathy is not detected. Biopsy of bone marrow revealed mild increase in reticular fibers, inter and paratrabecular lymphoid nodules and mild hypersellularity. Clinically, chronic lymphoproliferative disease or splenic lymphoma is suspected. For the purpose of diagnosis and treatment, splenectomy is performed. In the histopathologic examination of the spleen small lymphocytic type malign lymphoma is diagnosed. We present this rare case with the review of recent literature.