Primary Splenic Lymphoma, a Rare yet Possible Diagnosis: A Case Report and Review of the Literature

Introduction: The spleen is subject to a variety of benign and malignant disorders, which can be manifested by nonspecific symptoms or signs. Hence, the diagnosis is often made based on radiological examinations and histopathological studies. Case Presentation: Herein we present a case report of a patient with pathologically approved primary splenic lymphoma (PSL). The patient was a 63-year-old woman presented with abdominal pain, predominantly in the left upper quadrant, since 1 month. Complete blood count (CBC) was normal except for mild anemia. Liver enzyme studies showed an elevated alkaline phosphatase level. Ultrasound (US) depicted a huge hypoechoic splenic mass and computed tomography (CT) confirmed the lesion to be a hypodense mass partially exophytic from the superior aspect of the spleen measuring up to 124 mm in size. The patient underwent a midline laparotomy and splenectomy and the spleen was sent for histopathological examination, which revealed high-grade B-cell lymphoma measuring 17 x 16 x 10 cm in size with capsular invasion and without any lymphovascular invasion. Conclusions: This case report highlights the importance of considering splenic lymphoma as a differential diagnosis, although rare, in a patient with abdominal pain and nonspecific clinical findings.