Abstract
We describe a case of EBV associated primary malignant lymphoma of the spleen. An 80-year-old woman treated with methotrexate and tacrolimus for 1 year complained of general malaise for two weeks and a spiked fever for three days. There was percussion tenderness on her left upper quadrant, and contrast-enhanced CT showed multiple low density areas in the spleen. First, antibacterial and antifungal drugs were used because a splenic abscess was suspected. But the fever continued, and a hand-assisted laparoscopic splenectomy was conducted. There were multiple white nodules at the division surface of the spleen. On pathology, findings of a diffuse large B-cell lymphoma positive for EBER (EBV encoded small RNAs), were noted. An EBV-associated primary lymphoma of the spleen was diagnosed. After the operation the patient's fever subsided, and the patient was discharged since her general condition had improved.
