Abstract
A 74-year-old man who had had recurrent bouts of eruption of the whole body which started in August 2006 was referred to the department of dermatology in our hospital for the purpose of exploration of the cause in June 2007. His eruption was diagnosed as erythema multiforme, and possibilities of infection and drug-related allergy could be ruled out from the causative disorders. Abdominal CT scan for further exploration disclosed a tumorous lesion in the spleen, and then the patient was referred to our surgical department. Ga-scintigraphy and positron emission tomography (PET) showed abnormal accumulation of contrast materials at the same lesion. Blood biochemical studies provided positive reactions to both soluble IL-2 receptor antibody and thymidine kinase. From these findings, malignant lymphoma arisen in the spleen was diagnosed, and laparoscopy-assisted splenectomy was performed in September of the year. Relief of eruption was observed on the postoperative day 1, itching sensation disappeared on the pod 3, and thereafter erythema multiforme disappeared. The pathological diagnosis of the splenic lesion was diffuse large B cell lymphoma. Postoperative adjuvant chemotherapy was conducted, and the patient has been free from recurrence as of 10 months after the operation.
In this case the causal relationship between erythema multiforme and primary malignant lymphoma of the spleen has been suggested and the splenectomy has come to an extremely effective therapy for erythema multiforme.
