PMC9530245_01
CT scan of the thorax and abdomen showing (A) suspicious fistulous tract between colon and spleen (arrow) and (B) air in the spleen (arrow).
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F1
A hypodense area with air bubbles was also evident (Figure 1).
Surgical specimens containing splenic flexure, descending colon, and peripancreatic adipose tissue adhered and in close relationship with the medial surface of the spleen.
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F2
A solid whitish neoformation of 7 x 6 x 4 cm at the level of the splenic flexure was also evident (Figure 2).
Microscopic specimen of the spleen and colon. (A) Atypical lymphoma cells were found in the spleen on hematoxylin-eosin stain. (B) Evidence of capsular invasion by lymphoma cells. (C) Splenic hilum lymph node containing lymphoma cells. (D) Lymphoma cells found in the colon wall near the splenocolic fistula (10x magnification).
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F3
Histopathological examination of tissue samples confirmed that DLBCLextended to the splenic hilum, diffusely infiltrating the organ, the transverse mesocolon, the left flexure, and the adipose tissue of the pancreas tail (Figure 3).
Positivity for (A) CD20 and (B) CD43, indicating that it is large diffuse B-cell lymphoma (20x magnification).
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F4
Immunohistochemical analysis revealed CD20, CD43 (Figure 4), CD22, PAX5, CD45, and VIM (data not shown) protein expression.