Pathomorphological Verification of Diffuse Non-Hodgkin Lymphoma with Predominant Involvement of the Spleen and Abdominal Lymph Nodes

Abstract

The article presents a clinical observation of diffuse non-Hodgkin lymphoma with predominant involvement of the spleen and abdominal lymph nodes in a 59-year-old female patient, which during life manifested "under the guise" of fever of unknown origin, severe intoxication syndrome, and profound anemia. Instrumental studies revealed significant splenomegaly and a large focal lesion of the spleen in the absence of convincing evidence confirming gastrointestinal mucosal involvement. According to the results of trephine biopsy, the bone marrow material contained no reliable signs of specific lymphoid involvement. Final verification of the lymphoma was obtained posthumously based on an autopsy study with morphological confirmation of diffuse infiltration of the spleen by atypical large lymphoid cells with high mitotic activity and destruction of the organ architecture. This case demonstrates the limitations of antemortem diagnosis of lymphoproliferative diseases with predominantly visceral involvement and highlights the role of pathological autopsy as a tool for quality control of diagnosis.