Postchemotherapy histiocyte-rich pseudotumor involving the spleen.

Abstract:

:We report 2 cases of splenic postchemotherapy histiocyte-rich pseudotumor. Each patient had a history of diffuse large B-cell lymphoma, treated with multiagent chemotherapy. Computed tomography scans performed on both patients showed splenic masses. A positron emission tomography scan performed on 1 patient showed increased metabolic activity. The preoperative diagnosis in both patients was recurrent lymphoma, prompting splenectomy. The splenectomy specimens showed multiple, tan-white, firm nodules, up to 3.5 cm in diameter, that were histologically composed of central necrotic B cells (CD20+/CD3-), consistent with necrotic lymphoma, surrounded by numerous lipid-laden (xanthomatous) histiocytes. Clinical staging studies at the time of splenectomy showed no other sites of disease. We conclude that these histologic and immunophenotypic findings represent chemotherapy-induced tumor necrosis with a florid histiocytic reaction mimicking residual viable lymphoma. Others have used descriptive terminology or the term xanthomatous pseudotumor for these lesions that have been only rarely reported in the spleen previously.

journal_name

Am J Clin Pathol

authors

Chandra P,Wen YH,Tuli S,Raphael BG,Amorosi EL,Medeiros LJ,Ibrahim S

doi

10.1309/AJCPC67QOGJXCEZB

subject

Has Abstract

pub_date

2009-09-01 00:00:00

pages

342-8

issue

3

eissn

0002-9173

issn

1943-7722

pii

132/3/342

journal_volume

132

pub_type

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