Abstract
Background A 63-year-old Caucasian woman presented with intermittent, left-sided abdominal discomfort without other symptoms. Physical examination revealed massive splenomegaly and complete blood counts showed thrombocytopenia. Splenectomy was recommended but the patient declined. She was lost to follow-up twice but returned with tense ascites about 2 years after the initial presentation. Despite aggressive medical management, the ascites did not improve.
Investigations Bone-marrow and liver biopsies, abdominal ultrasound, esophagogastroduodenoscopy, abdominal CT scan and peripheral blood smear.
Diagnosis Primary splenic lymphoma with hepatic infiltration causing portal hypertension and ascites.
Management Paracentesis, dietary sodium restriction and diuretics, splenectomy, splenorenal shunt and chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone).
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References
Erslev AJ (2001) Hypersplenism and hyposplenism. In Williams Hematology, 683–687 (Eds Beutler E et al.) New York: McGraw-Hill
Bosch J et al. (2003) Portal hypertension. In Schiff's Diseases of the Liver, 430–485 (Eds Schiff ER et al.) Philadelphia: Lippincott, Williams & Wilkins
Wanless IR (1990) Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology 11: 787–797
Zhao H and Grabowski GA (2002) Gaucher disease: perspectives on a prototype lysosomal disease. Cell Mol Life Sci 59: 694–707
Chiu BC and Weisenburger DD (2003) An update of the epidemiology of non-Hodgkin's lymphoma. Clin Lymphoma 4: 161–168.
Dogan A and Isaacson PG (2003) Splenic marginal zone lymphoma. Semin Diagn Pathol 20: 121–127
Thieblemont C et al. (2003) Splenic marginal-zone lymphoma: a distinct clinical and pathological entity. Lancet Oncol 4: 95–103
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Lazaridis, K., Abraham, S. & Kamath, P. Hematological malignancy manifesting as ascites. Nat Rev Gastroenterol Hepatol 2, 112–116 (2005). https://doi.org/10.1038/ncpgasthep0095
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DOI: https://doi.org/10.1038/ncpgasthep0095