Abstract
A 72-year-old man who was under observation for prostatic hyperplasia was found to have multiple hypoechoic masses in the spleen and mild splenomegaly on abdominal ultrasound. Metastatic splenic tumor was suspected, but whole-body evaluation did not identify a primary lesion. All of the multiple splenic tumors (maximum diameter 10 mm) were observed to have grown on computed tomography (CT) 6 months later, with the largest reaching 23 mm in diameter. Although there was no systemic lymphadenopathy or elevation of lactate dehydrogenase (LDH), soluble interleukin-2 (IL2) receptor was mildly elevated, and the fact that the tumors were growing meant that the possibility of malignant lymphoma or other primary malignant tumors of the spleen could not be ruled out. Therefore, it was decided to remove the spleen for both diagnosis and treatment. Hand-assisted laparoscopic splenectomy was performed, and the undamaged spleen was sent for pathological testing. This led to a diagnosis of asymptomatic splenic marginal zone lymphoma, and the patient was discharged with no complications. Six years postoperatively, no recurrence has been identified to date. This case is reported along with a short discussion of the literature.
