PMC10348431_01
Abdominal MRI showing a non-specific multinodular splenomegaly, with multiple heterogeneous and confluent nodules, with cystic/necrotic expression, the largest measuring 11x9 cm (B, arrow). A: T1 weighted MRI, B: T2 weighted MRI
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The magnetic resonance imaging (MRI, Fig. 1) of the abdomen showed a multinodular splenomegaly of 15x11x17 (Fig. 1B, arrow).
Haematoxylin-eosin stained biopsy of the spleen showing areas of necrosis (*) and at higher magnification (x 400) revealing diffuse infiltration by neoplastic cells with large and hyperchromatic nuclei, with variably irregular nuclear contours and scant cytoplasm
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An ultrasound-guided biopsy of the spleen confirmed a primary splenic DLBCL, with non-germinal centre B-cell-like (non-GCB) immunophenotype (Fig. 2 and 3), configuring a stage I disease.
Immunophenotype featuring a non-germinal centre subtype diffuse large B-cell lymphoma. (A) Tumour cells are diffusely positive with CD20 immunohistochemical (IHC) stain; (B) positive with BCL2; (C) negative with CD10 IHC marker; (D) most tumour cells show immunopositivity for BCL-6; (E) strong nuclear expression is noted with MUM1 IHC marker; (F) Ki67 IHC stain depicts a high proliferative index (>90%) in tumour cells (x400 each)
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An ultrasound-guided biopsy of the spleen confirmed a primary splenic DLBCL, with non-germinal centre B-cell-like (non-GCB) immunophenotype (Fig. 2 and 3), configuring a stage I disease.