A CASE OF SPLEEN-ARISING MALIGNANT LYMPHOMA INVADED TAIL OF THE PANCREAS

A 45-year-old woman was admitted to the hospital because of back pain. From an increase in LDH3-5 and various imaging findings with abdominal CT scan, abdominal ultrasonography, and abdominal angiography, a malignant lymphoma arising in the spleen was strongly suspected. Laparotomy was carried out. The tumor was found to be a spleen-arising tumor, invading from the hilum of the spleen through tail of the pancreas. Splenectomy with resection of the tail of the pancreas including dissection of lymph nodes surrounding the hilum of the spleen and splenic arteries were performed. Pathohistologically the tumor was malignant lymphoma of diffused large cell type according to LSG classification. This case was diagnosed as to have a spleen-arising malignant lymphoma by Spier's diagnosis criteria.In general, cases of rupture of the spleen or of tumor invading other organs have been said having poor prognosis because of a rapid enlargement of the tumor. Prognosis in this case was also poor despite postoperative VEPA therapy.